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General NPI Number Information
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NPI Number | 1457525099
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Entity Type | Organization
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Legal Business Name | ROBIN OHEARN PHD INC
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Dates
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Enumeration Date | 04/15/2008
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Last Update Date | 04/15/2008
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Provider Practice Location Address
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Address Line | 4605 US HIGHWAY 17 STE. 2
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City | ORANGE PARK
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State | FL
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Zip | 32003-7866
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Country | US
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Telephone | 904-213-7521
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Fax | 904-213-8323
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Provider Business Mailing Address
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Address Line | 4605 US HIGHWAY 17 STE. 2
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City | ORANGE PARK
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State | FL
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Zip | 32003-7866
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Country | US
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Telephone | 904-213-7521
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Fax | 904-213-8323
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBIN ELIZABETH OHEARN
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Credential | PH.D.
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Telephone | 904-213-7521
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY7227
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License Number State | FL
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