Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 4494 | NC |
Y | 103T00000X | Psychologist | 4494 | NC |
N | 103TH0100X | Health Service |
NPI | 1184047268 |
---|---|
Provider Name | Dr. Clyde Robinette |
First Address | Greensboro, NC 27402-6170 |
Second Address | Greensboro, NC 27403-1830 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2014 |
Last Update Date | 02/09/2014 |