Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TA0400X | Addiction Psychologist (Substance Use Disorder) |
NPI | 1467699264 |
---|---|
Provider Name | Mr. Robert Charles Sterling |
First Address | Philadelphia, PA 19146-2634 |
Second Address | Philadelphia, PA 19146-2634 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/01/2009 |
Last Update Date | 15/01/2009 |