Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | 002279 | CT |
N | 103TC0700X | Clinical Psychologist | 002279 | CT |
N | 103TR0400X | Rehabilitation Psychologist | 002279 | CT |
NPI | 1346248200 |
---|---|
Provider Name | Dr. Robert Phillip Tepley |
First Address | Norwalk, CT 06851-5014 |
Second Address | Norwalk, CT 06851-5014 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2005 |
Last Update Date | 08/07/2007 |