Basic Information
| Provider Information | |||||||||
| NPI: | 1992873871 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MORRISON | ||||||||
| FirstName: | ROBLEY | ||||||||
| MiddleName: | H | ||||||||
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| Credential: | PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1820 | ||||||||
| Address2: | |||||||||
| City: | PRESQUE ISLE | ||||||||
| State: | ME | ||||||||
| PostalCode: | 047691820 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2077647529 | ||||||||
| FaxNumber: | 2077646504 | ||||||||
| Practice Location | |||||||||
| Address1: | 23 HIGH ST | ||||||||
| Address2: | |||||||||
| City: | FORT FAIRFIELD | ||||||||
| State: | ME | ||||||||
| PostalCode: | 047421021 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2074721200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/01/2006 | ||||||||
| LastUpdateDate: | 07/09/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | PS0000283 | ME | Y | Behavioral Health & Social Service Providers | Psychologist |
ID Information
| ID | Type | State | Issuer | Description | 004645 | 01 | ME | ANTHEM PROVIDER ID | OTHER |