Provider Demographics
NPI:1083728042
Name:GUIBORD, ROBERT LEONARD JR (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:LEONARD
Last Name:GUIBORD
Suffix:JR
Gender:M
Credentials:PSYD
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Mailing Address - Street 1:2388 UNIVERSITY AVE W
Mailing Address - Street 2:SUITE 209
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55114-1769
Mailing Address - Country:US
Mailing Address - Phone:651-245-3445
Mailing Address - Fax:651-333-4889
Practice Address - Street 1:2388 UNIVERSITY AVE W
Practice Address - Street 2:SUITE 209
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55114-1769
Practice Address - Country:US
Practice Address - Phone:651-245-3445
Practice Address - Fax:651-333-4889
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2015-04-13
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Provider Licenses
StateLicense IDTaxonomies
MNLP 4566103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical