Provider Demographics
NPI:1467494971
Name:DEWINDT-ROBSON, EDWARD C (PHD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:C
Last Name:DEWINDT-ROBSON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1311 WESTBROOK PLAZA DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-1327
Mailing Address - Country:US
Mailing Address - Phone:336-659-8202
Mailing Address - Fax:336-659-8206
Practice Address - Street 1:1311 WESTBROOK PLAZA DR
Practice Address - Street 2:SUITE 100
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-1327
Practice Address - Country:US
Practice Address - Phone:336-659-8202
Practice Address - Fax:336-659-8206
Is Sole Proprietor?:No
Enumeration Date:2006-06-11
Last Update Date:2007-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1467103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical