| Doctor Name: | ROBERT PRINCE |
| NPI Number: | 1114245776 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | B.S., LCADC |
| License Number: | LCA125 |
| Business Practice Address: | 30007 Business Center Dr Charlotte Hall, MD - 206223101 |
| Business Phone Number: | 3019971300 |
| Business Fax Number: | 3018634744 |
| Mailing Address: | 2019 Daffodil Rd, PORT REPUBLIC |
| State: | MD |
| Postal Code: | 206762645 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 05/06/2010 |
| NPI Last Update Date: | 05/06/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | LCA125 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |