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Individual

PROF. ROBERT EDWARD DOUGLAS II

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMFT. LPC

Contact information

Practice address
115 FRANKLIN AVE, FAIRVIEW, NJ 07022-1009
(901) 628-1843
Mailing address
115 FRANKLIN AVE, FAIRVIEW, NJ 07022-1009
(901) 628-1843

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
37PC01157100
NJ
106H00000X
Marriage & Family Therapist
37FI00243000
NJ

Other

Enumeration date
06/09/2025
Last updated
06/24/2025
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