Individual
NIKOLE K ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, LP
Contact information
Practice address
1300 E BRADFORD PKWY BLDG B, SPRINGFIELD, MO 65804-4264
(417) 761-5000
(417) 761-5065
Mailing address
2885 W BATTLEFIELD ST, SPRINGFIELD, MO 65807-3952
(417) 761-5000
(417) 761-5065
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2019037970
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14491942
CAQH
—
Enumeration date
06/25/2019
Last updated
04/30/2026
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