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General NPI Number Information
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NPI Number | 1871745406
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Entity Type | Individual
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Provider Name | CAROL ARLENE MOSES-ROBINSON MA, PSYD
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Gender | Female
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Dates
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Enumeration Date | 10/14/2008
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Last Update Date | 02/24/2010
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Provider Practice Location Address
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Address Line | 110 E 79TH ST
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City | CHICAGO
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State | IL
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Zip | 60619-2302
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Country | US
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Telephone | 773-562-5923
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Fax | 773-288-0479
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Provider Business Mailing Address
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Address Line | 7430 S PAXTON AVE
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City | CHICAGO
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State | IL
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Zip | 60649-3215
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Country | US
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Telephone | 773-288-0479
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Fax | 773-288-0479
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 20042064A
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License Number State | IN
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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 | 071.007855
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149.004604
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License Number State | IL
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