Provider Demographics
NPI:1992986145
Name:ROBISON, PHILIP DEAN (PHD)
Entity type:Individual
Prefix:
First Name:PHILIP
Middle Name:DEAN
Last Name:ROBISON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9005 CHEVROLET DR STE D
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-4035
Mailing Address - Country:US
Mailing Address - Phone:410-461-1382
Mailing Address - Fax:410-465-5967
Practice Address - Street 1:9005 CHEVROLET DR STE D
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-4035
Practice Address - Country:US
Practice Address - Phone:410-461-1382
Practice Address - Fax:410-465-5967
Is Sole Proprietor?:No
Enumeration Date:2007-11-15
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD828103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist