| Doctor Name: | DR. ROBERT PAUL MADDOX |
| NPI Number: | 1538456231 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D., NCC, LPC |
| License Number: | 2011014540 |
| Business Practice Address: | 508 S Basswood Ave Republic, MO - 657382173 |
| Business Phone Number: | 5735871652 |
| Business Fax Number: | |
| Mailing Address: | 508 S Basswood Ave, REPUBLIC |
| State: | MO |
| Postal Code: | 657382173 |
| Phone Number: | 5735871652 |
| Fax Number: | |
| NPI Enumeration Date: | 07/01/2011 |
| NPI Last Update Date: | 01/05/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 2011014540 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |