Individual
MR. DARRELL DEWAYNE ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2725 N WESTWOOD BLVD, STE.5A, POPLAR BLUFF, MO 63901-2346
(573) 785-0333
Mailing address
2725 N WESTWOOD BLVD, STE.5A, POPLAR BLUFF, MO 63901-2346
(573) 785-0333
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
2011012790
MO
Other
Enumeration date
05/16/2011
Last updated
05/16/2011
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