Provider Demographics
NPI:1013101385
Name:WARD, ROBIN MICHAEL (PSYD)
Entity type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:MICHAEL
Last Name:WARD
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1845 WALNUT ST STE 945
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19103-4709
Mailing Address - Country:US
Mailing Address - Phone:610-506-5888
Mailing Address - Fax:
Practice Address - Street 1:1845 WALNUT ST STE 945
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19103-4709
Practice Address - Country:US
Practice Address - Phone:610-506-5888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-30
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS 016279103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist