Provider Demographics
NPI:1063868248
Name:BARTLETT, ROBERT FREDERICK II
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:FREDERICK
Last Name:BARTLETT
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7400 METRO BLVD
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55439-2316
Mailing Address - Country:US
Mailing Address - Phone:952-831-2000
Mailing Address - Fax:952-831-2002
Practice Address - Street 1:7400 METRO BLVD
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55439-2316
Practice Address - Country:US
Practice Address - Phone:952-831-2000
Practice Address - Fax:952-831-2002
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-06
Last Update Date:2016-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN#3163101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty