Individual
DR. ROBERT CLARK PENNELL
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
3959 S NOVA RD, SUITE 5, PORT ORANGE, FL 32127-9278
(386) 761-2390
(386) 761-3256
Mailing address
3959 S NOVA RD, SUITE 5, PORT ORANGE, FL 32127-9278
(386) 761-2390
(386) 761-3256
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
SW3855
FL
174400000X
Specialist
SW3855
FL
Other
Enumeration date
06/14/2006
Last updated
09/11/2025
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