Individual
ROBERT EDWARD DEAKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
1301 W PHELPS ST, SPRINGFIELD, MO 65802-4234
(417) 619-5954
Mailing address
1301 W PHELPS ST, SPRINGFIELD, MO 65802-4234
(417) 619-5954
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
2003024989
MO
390200000X
Student in an Organized Health Care Education/Training Program
Primary
GOLDCARD
WV
Other
Enumeration date
07/22/2006
Last updated
09/22/2008
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