Individual
MR. ROBERT W GOTWALT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS CCDP DIPLOMATE
Contact information
Practice address
120 EAST AZALEA DRIVE, HBG., PA 17110-3594
(717) 772-7513
(717) 772-7699
Mailing address
PO BOX 2675, DPW-OMHSAS LOGAN BUILDING, HARRISBURG, PA 17105-2675
(717) 772-7513
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CERT.# 6218
PA
Other
Enumeration date
03/26/2007
Last updated
07/08/2007
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