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General NPI Number Information
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NPI Number | 1518361757
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Entity Type | Individual
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Provider Name | DAVID ROBB
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Gender | Male
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Dates
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Enumeration Date | 10/17/2014
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Last Update Date | 09/28/2022
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Provider Practice Location Address
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Address Line | 2935 BAGNELL DAM BLVD STE 124
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City | LAKE OZARK
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State | MO
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Zip | 65049-8661
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Country | US
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Telephone | 573-557-9795
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Fax |
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Provider Business Mailing Address
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Address Line | 2935 BAGNELL DAM BLVD STE 124
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City | LAKE OZARK
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State | MO
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Zip | 65049-8661
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Country | US
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Telephone | 573-557-9795
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Fax | 573-746-2686
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 2015029906
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License Number State | MO
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