Individual
BO DEAN ROBERTSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
483 N AVIATION BLVD BLDG 210, EL SEGUNDO, CA 90245-2808
(310) 653-6860
Mailing address
1983 SPRING RIDGE DR, XENIA, OH 45385-9800
(808) 352-3073
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
01/08/2021
Last updated
02/27/2024
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