Provider Demographics
NPI:1881997658
Name:NEWMAN, MARY ROBIN (PSYD)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:ROBIN
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 E SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:LINDALE
Mailing Address - State:TX
Mailing Address - Zip Code:75771-3490
Mailing Address - Country:US
Mailing Address - Phone:719-260-1221
Mailing Address - Fax:
Practice Address - Street 1:305 E SOUTH ST
Practice Address - Street 2:STE 102
Practice Address - City:LINDALE
Practice Address - State:TX
Practice Address - Zip Code:75771-3490
Practice Address - Country:US
Practice Address - Phone:719-260-1221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-16
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3521103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical