Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | 1247 | LA |
N | 103TC0700X | Clinical Psychologist | 1247 | LA |
Y | 103TP0016X | Prescribing (Medical) | 300762 | LA |
N | 103TR0400X | Rehabilitation Psychologist | 1247 | LA |
NPI | 1407252604 |
---|---|
Provider Name | Dr. Robert L Gervey |
First Address | Metairie, LA 70006-1022 |
Second Address | New Orleans, LA 70114-6757 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2014 |
Last Update Date | 06/02/2016 |