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General NPI Number Information
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NPI Number | 1285331082
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Entity Type | Individual
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Provider Name | STEPHANIE ROBERTSON PHD
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Gender | Female
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Dates
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Enumeration Date | 02/13/2023
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Last Update Date | 03/22/2023
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Provider Practice Location Address
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Address Line | 1333 W WASHINGTON T-1052
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City | STEPHENVILLE
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State | TX
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Zip | 76402-1745
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Country | US
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Telephone | 254-968-9813
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Fax |
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Provider Business Mailing Address
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Address Line | 1333 W WASHINGTON ST # T-1052
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City | STEPHENVILLE
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State | TX
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Zip | 76401-4168
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Country | US
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Telephone | 704-678-0053
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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 | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 70480
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 36562
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License Number State | TX
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