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Individual

ROBERT BERIDHA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
711 N BEAVER ST, FLAGSTAFF, AZ 86001-3103
(928) 380-6081
Mailing address
711 N BEAVER ST, FLAGSTAFF, AZ 86001-3103
(541) 301-1138

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
R4311
OR
103T00000X
Psychologist
Primary
PSY-005043
AZ
103T00000X
Psychologist
103TC0700X
Clinical Psychologist
005043
AZ
103TP2701X
Group Psychotherapy Psychologist
005043
AZ

Other

Enumeration date
05/29/2014
Last updated
02/19/2023
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