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General NPI Number Information
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NPI Number | 1134176936
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Entity Type | Individual
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Provider Name | ROBERT DE LA TORRE PSYD
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Gender | Male
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Dates
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Enumeration Date | 05/27/2006
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Last Update Date | 12/22/2015
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Provider Practice Location Address
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Address Line | 192 CLARENDON CIR
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City | FRANKLIN
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State | TN
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Zip | 37069-1836
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Country | US
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Telephone | 615-414-6874
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Fax |
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Provider Business Mailing Address
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Address Line | 192 CLARENDON CIR
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City | FRANKLIN
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State | TN
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Zip | 37069-1836
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Country | US
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Telephone | 615-414-6874
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | P2251
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License Number State | TN
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