Provider Demographics
NPI:1588979157
Name:LAWSON, ROBERT VINCENT SR
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:VINCENT
Last Name:LAWSON
Suffix:SR
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 1:5945 DEL LAGO CIR
Mailing Address - Street 2:APARTMENT 303
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33313-6300
Mailing Address - Country:US
Mailing Address - Phone:954-316-1016
Mailing Address - Fax:954-316-1016
Practice Address - Street 1:5945 DEL LAGO CIR
Practice Address - Street 2:APARTMENT 303
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33313-6300
Practice Address - Country:US
Practice Address - Phone:954-316-1016
Practice Address - Fax:954-316-1016
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-08
Last Update Date:2010-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor