Doctor Name: | DR. ROBERT STEVEN HEATH |
NPI Number: | 1023194453 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PH.D. |
License Number: | 23244 |
Business Practice Address: | 1510 N Hampton Rd #250 Desoto, TX - 751152269 |
Business Phone Number: | 9722248606 |
Business Fax Number: | 9722249403 |
Mailing Address: | 1813 N Westmoreland Rd, DESOTO |
State: | TX |
Postal Code: | 751152269 |
Phone Number: | 9722248606 |
Fax Number: | 9725727297 |
NPI Enumeration Date: | 10/27/2006 |
NPI Last Update Date: | 09/02/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 23244 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |