Individual
ROBERT CHILDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
789 MULBERRY ST., ELIZABETH, WV 26143-0189
(304) 485-6513
Mailing address
1 MULBERRY ST, ELIZABETH, WV 26143-0189
(304) 485-6513
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
22055
WV
Other
Enumeration date
04/04/2014
Last updated
04/04/2014
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