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General NPI Number Information
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NPI Number | 1861538605
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Entity Type | Individual
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Provider Name | DAVID DOUGLAS ROBY LISW-S
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Gender | Male
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Dates
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Enumeration Date | 01/29/2007
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Last Update Date | 09/13/2021
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Provider Practice Location Address
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Address Line | 4881 SUGAR MAPLE DR
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City | DAYTON
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State | OH
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Zip | 45433-5529
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Country | US
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Telephone | 973-257-6877
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Fax |
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Provider Business Mailing Address
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Address Line | 6128 MAUD HUGHES RD
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City | LIBERTY TOWNSHIP
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State | OH
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Zip | 45044-9752
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Country | US
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Telephone | 513-257-3207
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I 0700010
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License Number State | OH
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