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General NPI Number Information
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NPI Number | 1770612657
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Entity Type | Individual
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Provider Name | ROBERT J. RITZEMA PH.D.
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Gender | Male
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 01/30/2018
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Provider Practice Location Address
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Address Line | 114 HIGHLAND AVE
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City | FAYETTEVILLE
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State | NC
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Zip | 28305-5306
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Country | US
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Telephone | 910-484-0176
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Fax | 910-484-5781
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Provider Business Mailing Address
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Address Line | 901 ARSENAL AVE STE 202
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City | FAYETTEVILLE
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State | NC
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Zip | 28305-5478
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Country | US
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Telephone | 910-323-3368
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Fax | 910-486-7000
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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 | 103TH0100X
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Taxonomy Name | Health Service Psychologist
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License Number | 791
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License Number State | NC
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