Provider Demographics
NPI:1821211103
Name:TAUBE, ROBERT L (PHD)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:L
Last Name:TAUBE
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 1:729 MASSACHUSETTS AVE
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2318
Mailing Address - Country:US
Mailing Address - Phone:857-654-1000
Mailing Address - Fax:617-414-5418
Practice Address - Street 1:729 MASSACHUSETTS AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-2318
Practice Address - Country:US
Practice Address - Phone:857-654-1000
Practice Address - Fax:617-414-5418
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1803103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling