Provider Demographics
NPI:1992704621
Name:ROBB, PAUL (PSYD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:ROBB
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 CEDAR PLAZA PARKWAY
Mailing Address - Street 2:STE 350
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63128-3441
Mailing Address - Country:US
Mailing Address - Phone:314-843-4333
Mailing Address - Fax:314-843-4856
Practice Address - Street 1:205 ELM ST
Practice Address - Street 2:SUITE 202
Practice Address - City:WASHINGTON
Practice Address - State:MO
Practice Address - Zip Code:63090-2326
Practice Address - Country:US
Practice Address - Phone:636-390-4071
Practice Address - Fax:636-390-8908
Is Sole Proprietor?:No
Enumeration Date:2005-07-15
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO01562103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist