Provider Demographics
NPI:1194766337
Name:HOROWITZ, ROBERT STANLEY (PHD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:STANLEY
Last Name:HOROWITZ
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:777 NW WALL ST
Mailing Address - Street 2:#305
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-2731
Mailing Address - Country:US
Mailing Address - Phone:541-598-5850
Mailing Address - Fax:541-389-9095
Practice Address - Street 1:777 NW WALL ST
Practice Address - Street 2:#305
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-2731
Practice Address - Country:US
Practice Address - Phone:541-598-5850
Practice Address - Fax:541-389-9095
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2007-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR#1764103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical