Individual
JEFFREY R ROBERTSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
6840 PRAIRIE RUN AVE, PORTAGE, IN 46368-2665
(219) 763-4767
Mailing address
6840 PRAIRIE RUN AVE, PORTAGE, IN 46368-2665
(219) 763-4767
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34001418A
IN
Other
Enumeration date
05/11/2006
Last updated
07/08/2007
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