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General NPI Number Information
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NPI Number | 1265783831
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Entity Type | Individual
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Provider Name | TRISTAN ROBINSON PH.D.
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Gender | Female
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Dates
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Enumeration Date | 09/24/2012
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Last Update Date | 11/26/2024
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Provider Practice Location Address
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Address Line | 646 HAZELWOOD RD
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City | ARDMORE
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State | PA
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Zip | 19003
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Country | US
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Telephone | 302-455-8772
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Fax | 302-416-5505
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Provider Business Mailing Address
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Address Line | 646 HAZELWOOD RD
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City | ARDMORE
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State | PA
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Zip | 19003-1828
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Country | US
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Telephone | 302-455-8772
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Fax | 302-416-5505
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PS018284
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | B1-0001135
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License Number State | DE
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