MEDICARE: MR. DAVID DOUGLAS ROBY LISW-S

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	I 0700010	OH

General Provider Information

NPI Number	:	1861538605
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAVID DOUGLAS ROBY LISW-S

Provider Business Mailing Address
First Line	:	6128 MAUD HUGHES RD
Second Line	:
City	:	LIBERTY TOWNSHIP
State	:	OH
Zip	:	45044-9752
Country	:	US
Telephone Number	:	513-257-3207
Fax Number	:

Provider Business Practice Location Address
First Line	:	4881 SUGAR MAPLE DR
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45433-5529
Country	:	US
Telephone Number	:	973-257-6877
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2007
Last Update Date	:	09/13/2021

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