Provider Demographics
NPI:1487853586
Name:MCBRADY, ROBERT MICHAEL (PHD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MICHAEL
Last Name:MCBRADY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9900 CINCINNATI-COLUMBUS ROAD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45241-1209
Mailing Address - Country:US
Mailing Address - Phone:513-779-9900
Mailing Address - Fax:513-779-9900
Practice Address - Street 1:9900 CINCINNATI-COLUMBUS ROAD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45241-1209
Practice Address - Country:US
Practice Address - Phone:513-779-9900
Practice Address - Fax:513-779-9900
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-17
Last Update Date:2012-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1809103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist