Doctor Name: | MR. ROBERT MAHONEY |
NPI Number: | 1710017884 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW |
License Number: | S11965 |
Business Practice Address: | 364 Alexandra Dr Tuscola, TX - 795623648 |
Business Phone Number: | 3256650618 |
Business Fax Number: | 3255725423 |
Mailing Address: | 364 Alexandra Dr, TUSCOLA |
State: | TX |
Postal Code: | 795623648 |
Phone Number: | 3256650618 |
Fax Number: | 3255725423 |
NPI Enumeration Date: | 03/06/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | S11965 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |