Provider Demographics
NPI:1194390567
Name:ADAMS, ROBERT WILLIAM (PHD MBA)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:WILLIAM
Last Name:ADAMS
Suffix:
Gender:M
Credentials:PHD MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 PRIMROSE CV
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38117-3645
Mailing Address - Country:US
Mailing Address - Phone:901-482-0155
Mailing Address - Fax:
Practice Address - Street 1:1661 INTERNATIONAL PLACE DR STE 400
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-1431
Practice Address - Country:US
Practice Address - Phone:901-767-7771
Practice Address - Fax:901-767-4441
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-26
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3673103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist