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General NPI Number Information
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NPI Number | 1417090838
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Entity Type | Organization
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Legal Business Name | ROBERT KEITH ALBISTON
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Dates
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Enumeration Date | 02/15/2007
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Last Update Date | 08/17/2007
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Provider Practice Location Address
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Address Line | 1002 BRADFORD WAY
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City | KINGSTON
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State | TN
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Zip | 37763-3100
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Country | US
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Telephone | 865-376-1585
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Fax | 865-376-1587
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Provider Business Mailing Address
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Address Line | 1002 BRADFORD WAY
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City | KINGSTON
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State | TN
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Zip | 37763-3100
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Country | US
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Telephone | 865-376-1585
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Fax | 865-376-1587
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBERT K ALBISTON
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Credential | PH.D.
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Telephone | 865-375-1585
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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 | P1001
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License Number State | TN
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