Doctor Name: | MR. ROBERT PROCTOR |
NPI Number: | 1659574234 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.ED. |
License Number: | 5329 |
Business Practice Address: | 383 Franklin St Wrentham, MA - 020932405 |
Business Phone Number: | 5083338290 |
Business Fax Number: | |
Mailing Address: | 383 Franklin St, WRENTHAM |
State: | MA |
Postal Code: | 020932405 |
Phone Number: | 5083338290 |
Fax Number: | |
NPI Enumeration Date: | 06/08/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 5329 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |