Healthcare Provider Details

I. General information

NPI: 1104916279
Provider Name (Legal Business Name): ROBIN T HORNSTEIN PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 S 17TH ST SUITE 1405
PHILADELPHIA PA
19103-6231
US

IV. Provider business mailing address

516 SPRAGUE RD
NARBERTH PA
19072-1235
US

V. Phone/Fax

Practice location:
  • Phone: 610-617-1088
  • Fax: 215-732-8240
Mailing address:
  • Phone: 610-617-1088
  • Fax: 215-732-8240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPS-006265-L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: