MEDICARE: KRISTIN E. ROBINSON PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	140191-2501	UT

General Provider Information

NPI Number	:	1104804194
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTIN E. ROBINSON PHD

Provider Business Mailing Address
First Line	:	7069 S HIGHLAND DR STE 100
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84121-3731
Country	:	US
Telephone Number	:	801-230-8785
Fax Number	:

Provider Business Practice Location Address
First Line	:	7069 S HIGHLAND DR STE 100
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84121-3731
Country	:	US
Telephone Number	:	801-382-9197
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2006
Last Update Date	:	08/27/2024

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