Individual
ROBERT L MAILLIARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYCHOLOGIST
Contact information
Practice address
120 E 2ND ST, THIRD FLOOR, ERIE, PA 16507-1537
(814) 877-8013
(814) 877-8007
Mailing address
120 E 2ND ST, THIRD FLOOR, ERIE, PA 16507-1537
(814) 877-8013
(814) 877-8007
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS016253
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1019567000
—
PA
Enumeration date
07/06/2007
Last updated
08/19/2015
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