| Doctor Name: | ROBERT SODERBERG |
| NPI Number: | 1972716116 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 43 W Main St Vernon Rockville, CT - 060663549 |
| Business Phone Number: | 8608718227 |
| Business Fax Number: | 8608758299 |
| Mailing Address: | 94 Warrenville Rd, MANSFIELD CENTER |
| State: | CT |
| Postal Code: | 062501228 |
| Phone Number: | 8604234161 |
| Fax Number: | |
| NPI Enumeration Date: | 05/07/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |