Provider Demographics
NPI:1396787404
Name:SCHUPPER, ROBIN L (PSYD)
Entity type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:L
Last Name:SCHUPPER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7693 THORNLEE DR
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-7858
Mailing Address - Country:US
Mailing Address - Phone:561-704-2304
Mailing Address - Fax:561-432-4477
Practice Address - Street 1:901 S 62ND AVE
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33023-1848
Practice Address - Country:US
Practice Address - Phone:561-704-2304
Practice Address - Fax:561-432-4477
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2010-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY4131103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical