Individual
DR. ROBERT THAYER FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
2112 RIVERDALE ST, WEST SPRINGFIELD, MA 01089-1024
(413) 539-2972
Mailing address
45 ASNEBUMSKIT RD, PAXTON, MA 01612-1350
(508) 797-2140
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
7632
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0502651
—
MA
Enumeration date
08/19/2006
Last updated
11/14/2009
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