Doctor Name: | MR. ROBERT P OUELLETTE |
NPI Number: | 1366756371 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 9003 |
Business Practice Address: | 1000 W 29th St Suite 319 South Sioux City, NE - 687763852 |
Business Phone Number: | 4024944904 |
Business Fax Number: | 4024941210 |
Mailing Address: | 1000 W 29th St, Suite 319 SOUTH SIOUX CITY |
State: | NE |
Postal Code: | 687763852 |
Phone Number: | 4024944904 |
Fax Number: | 4024941210 |
NPI Enumeration Date: | 08/02/2010 |
NPI Last Update Date: | 08/02/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 9003 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NE |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |