Doctor Name: | MR. PETER D. ROBERTSON |
NPI Number: | 1275640849 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | L.C.S.W. |
License Number: | LC3086 |
Business Practice Address: | 226a Portland Road Rte 302 Bridgton, ME - 040050000 |
Business Phone Number: | 2076472037 |
Business Fax Number: | 2076472037 |
Mailing Address: | Po Box 96, HARRISON |
State: | ME |
Postal Code: | 040400096 |
Phone Number: | 2076472037 |
Fax Number: | 2076472037 |
NPI Enumeration Date: | 08/23/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | LC3086 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ME |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |