Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 15-16P | AR |
N | 103T00000X | Psychologist | 15-16P | AR |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 15-16P | AR |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 15-16P | AR |
Y | 103G00000X | Clinical Psychologist | 15-16P | AR |
Y | 103TC0700X | Clinical Psychologist | 15-16P | AR |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 15-16P | AR |
N | 103TF0000X | Family Psychologist | 15-16P | AR |
N | 103TH0004X | Health Psychologist | 15-16P | AR |
N | 103TP2701X | Group Psychotherapist | 15-16P | AR |
N | 103TS0200X | School Psychologist | 15-16P | AR |
NPI | 1265951784 |
---|---|
Provider Name | Robert D Felner |
First Address | Fayetteville, AR 72701 |
Second Address | Fayetteville, AR 72701-2892 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2017 |
Last Update Date | 15/09/2017 |