Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 1811 | DC |
N | 103TA0700X | Adult Development & Aging Psychologist | 1811 | DC |
N | 103G00000X | Clinical Psychologist | 2430 | MD |
N | 103TC0700X | Clinical Psychologist | 2430 | MD |
Y | 103TC1900X | Counseling Psychologist | 1811 | DC |
N | 103TP2701X | Group Psychotherapist | 1811 | DC |
NPI | 1083899231 |
---|---|
Provider Name | Dr. Robert Glen Rosenblatt |
First Address | Washington, DC 20007-3603 |
Second Address | Washington, DC 20007-3603 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/01/2008 |
Last Update Date | 07/01/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1811 | DC PROFESSIONAL LICENSING (01) | DC |
2430 | MARYLAND LICENSING BOARD (01) | MD |