Robertson, Bruce J.
Robertson, Bruce J. is an individual health care provider with primary practice located at 2631 Packerland Dr Suite 104-C, Green Bay WI 54313-4130. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Robertson, Bruce J. can be contacted via phone (920) 965-7701.Contact Information
Primary practice address
2631 Packerland Dr Suite 104-C
Green Bay WI 54313-4130
Phone: (920) 965-7701
Fax: (920) 497-4956
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 1992-057 | Wisconsin |
Profile Details
| NPI number | 1396770434 |
|---|---|
| LBN Legal business name | Robertson, Bruce J. |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 11th, 2006 |
| Last updated | Sep 12th, 2009 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1396770434 | NPPES |
| Wisconsin | MEDICAID | 39699400 |
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