Doctor Name: | MR. ROBERT DERNER |
NPI Number: | 1013317411 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | BH001121 |
Business Practice Address: | 2700 Commerce Dr. Harrisburg, PA - 17110 |
Business Phone Number: | 7179019906 |
Business Fax Number: | |
Mailing Address: | 2700 Commerce Dr, HARRISBURG |
State: | PA |
Postal Code: | 171109365 |
Phone Number: | 7179019906 |
Fax Number: | |
NPI Enumeration Date: | 09/04/2014 |
NPI Last Update Date: | 09/04/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | BH001121 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |