Provider Demographics
NPI:1083831416
Name:WEBSTER, RONALD L (PHD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:L
Last Name:WEBSTER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7851 ENON DR
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24019-1515
Mailing Address - Country:US
Mailing Address - Phone:540-265-5666
Mailing Address - Fax:540-265-0386
Practice Address - Street 1:7851 ENON DR
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24019-1515
Practice Address - Country:US
Practice Address - Phone:540-265-5666
Practice Address - Fax:540-265-0386
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810002584103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical