Healthcare Provider Details

I. General information

NPI: 1023935269
Provider Name (Legal Business Name): ROBIN WISNIEWSKI PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7953 FLORADO ST
DENVER CO
80221-4213
US

IV. Provider business mailing address

7953 FLORADO ST
DENVER CO
80221-4213
US

V. Phone/Fax

Practice location:
  • Phone: 216-870-8871
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number6639
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: