Healthcare Provider Details

I. General information

NPI: 1548568462
Provider Name (Legal Business Name): ROBYN MCKAY PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2011
Last Update Date: 03/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6049 SOUTH BACKUS MALL, SUTTON HALL SUITE 240 ARIZONA STATE UNIVERSITY POLYTECHNIC CAMPUS
MESA AZ
85212-0000
US

IV. Provider business mailing address

6049 S BACKUS MALL SUTTON HALL-SUITE 240 ARIZONA STATE UNIVERSITY POLYTECHNIC CAMPUS
MESA AZ
85212
US

V. Phone/Fax

Practice location:
  • Phone: 480-727-1527
  • Fax:
Mailing address:
  • Phone: 480-727-1527
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number4137
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: