Individual
ROBERT JOSH LYDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
272 NW MEDICAL LOOP STE E, ROSEBURG, OR 97471-5545
(541) 900-4285
(888) 810-2993
Mailing address
272 NW MEDICAL LOOP STE E, ROSEBURG, OR 97471-5545
(541) 900-4285
(888) 810-2993
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
OR
1041C0700X
Clinical Social Worker
Primary
L7631
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500712185
—
OR
Enumeration date
09/07/2011
Last updated
06/13/2019
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