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NPI Code Detail

MEDICARE: MR. ROBERT TERRY MSSA, LISW-S

MEDICARE: MR. ROBERT TERRY MSSA, LISW-S
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerI7919OH

General Provider Information

NPI Number : 1033372719
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ROBERT TERRY MSSA, LISW-S
Provider Business Mailing Address
First Line : 725 E MARKET ST
Second Line :
City : AKRON
State : OH
Zip : 44305-2421
Country : US
Telephone Number : 330-315-3756
Fax Number :
Provider Business Practice Location Address
First Line : 702 E MARKET ST
Second Line :
City : AKRON
State : OH
Zip : 44305-2422
Country : US
Telephone Number : 330-315-3756
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2008
Last Update Date : 02/18/2016

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