Provider Demographics
NPI:1124245360
Name:ROBBINS, ELIZABETH ANN (PHD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANN
Last Name:ROBBINS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2641 INDIAN MOUND SOUTH
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48301
Mailing Address - Country:US
Mailing Address - Phone:248-647-2837
Mailing Address - Fax:
Practice Address - Street 1:999 HAYNES
Practice Address - Street 2:SUITE 300
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009
Practice Address - Country:US
Practice Address - Phone:248-770-3536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301010919103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI68OF333190OtherBLUE CROSS PROVIDER ID
11287042OtherCAQH REGISTRATION NUMBER