Provider Information for 1760775571
The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.
Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know
Mr. ROBERT FREDERICK WUBBENHORST LCMHC
Sex: Male
NPI: 1760775571
Last Updated: 2011-05-26
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1760775571 | ||||||||
| Enumeration Date | 2011-05-26 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 246 FLAMSTEAD RD CHESTER, VT 05143-8893 United States Phone: 802-428-2008 | Fax: | ||||||||
| Primary Practice Address | 246 FLAMSTEAD RD CHESTER, VT 05143-8893 United States Phone: 802-428-2008 | Fax: | ||||||||
| Secondary Practice Address(es) | |||||||||
| Health Information Exchange |
| ||||||||
| Other Identifiers |
| ||||||||
| Taxonomy |
|