Provider Demographics
NPI:1720198807
Name:OUAOU, ROBERT HASSEN (PHD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:HASSEN
Last Name:OUAOU
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:679 110TH AVE N
Mailing Address - Street 2:NAPLES NEUROPSYCHOLOGY, P.A.
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34108-1817
Mailing Address - Country:US
Mailing Address - Phone:239-514-3003
Mailing Address - Fax:239-514-7009
Practice Address - Street 1:2450 GOODLETTE RD N STE 101
Practice Address - Street 2:NAPLES NEUROPSYCHOLOGY, P.A.
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-4595
Practice Address - Country:US
Practice Address - Phone:239-514-3003
Practice Address - Fax:239-514-7009
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2008-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6868103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U1943ZMedicare ID - Type Unspecified
S51433Medicare UPIN