Iddings, Robert R

Iddings, Robert R is an sole proprietor health care provider with primary practice located at 1363 W 6Th St , Erie PA 16505-2559. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Psychologist is his primary health care specialty. Iddings, Robert R can be contacted via phone (814) 490-4740.

Contact Information

Primary practice address
1363 W 6Th St Erie PA 16505-2559
Phone: (814) 490-4740
Fax: (814) 455-0754
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X LP004193 Pennsylvania
Behavioral Health & Social Service Providers / Psychologist 103T00000X PS016657L Pennsylvania
Behavioral Health & Social Service Providers / Clinical 103TC0700X PS016657L Pennsylvania

Profile Details

NPI number 1710085105
LBN Legal business name Iddings, Robert R
Credentials PH. D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 20th, 2006
Last updated Aug 13th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710085105 NPPES
Pennsylvania Other PC004193 PROFESSIONAL COUN LICENSE
Pennsylvania Other PS016657L PROFESSIONAL COUN LICENSE

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