Healthcare Provider Details

I. General information

NPI: 1184707002
Provider Name (Legal Business Name): WILLIAM N ROBINER PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 DELAWARE ST SE PWB THIRD FLOOR, CLINIC 3A
MINNEAPOLIS MN
55455-0356
US

IV. Provider business mailing address

420 DELAWARE STREET SE UNIVERSITY OF MINNESOTA PHYSICIANS
MINNEAPOLIS FM
55455
US

V. Phone/Fax

Practice location:
  • Phone: 612-884-0999
  • Fax:
Mailing address:
  • Phone: 612-884-0999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License NumberLP0379
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: