Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | ||
N | 103TA0700X | Adult Development & Aging Psychologist | ||
N | 103TB0200X | Cognitive & Behavioral Psychologist | ||
Y | 103G00000X | Clinical Psychologist | 6606 | OH |
Y | 103TC0700X | Clinical Psychologist | 6606 | OH |
N | 103TH0004X | Health Psychologist | ||
N | 103TR0400X | Rehabilitation Psychologist |
NPI | 1245561448 |
---|---|
Provider Name | Dr. Robert F Dalton |
First Address | Galena, OH 43021-9638 |
Second Address | Galena, OH 43021-9638 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2010 |
Last Update Date | 14/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P00994146 | MEDICARE RAILROAD (01) | OH |