| Robyn L Wallace Phd Llc | |
|
2141 S Alternate A1a Ste 300 Jupiter FL 33477-4063 | |
| (561) 301-2908 | |
| Not Available |
| Full Name | Robyn L Wallace Phd Llc |
|---|---|
| Speciality | Psychologist |
| Location | 2141 S Alternate A1a Ste 300, Jupiter, Florida |
| Authorized Official Name and Position | Robyn L Walker (PRESIDENT) |
| Authorized Official Contact | 5613012908 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Robyn L Wallace Phd Llc 2141 S Alternate A1a Ste 300 Jupiter FL 33477-4063 Ph: (561) 301-2908 | Robyn L Wallace Phd Llc 2141 S Alternate A1a Ste 300 Jupiter FL 33477-4063 Ph: (561) 301-2908 |
| NPI Number | 1316473028 |
|---|---|
| Provider Enumeration Date | 05/02/2017 |
| Last Update Date | 09/18/2019 |
| Medicare PECOS PAC ID | 5890060347 |
|---|---|
| Medicare Enrollment ID | O20171009002746 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316473028 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Robyn Wallace |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1598866071 PECOS PAC ID: 1153515275 Enrollment ID: I20101103000293 |
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