Provider Demographics
NPI:1922231406
Name:QUINBY, ROBERT FREEMAN (PHD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:FREEMAN
Last Name:QUINBY
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 1:507 BURROUGHS ST APT 101
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-3392
Mailing Address - Country:US
Mailing Address - Phone:304-293-4431
Mailing Address - Fax:
Practice Address - Street 1:1550 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26506-0001
Practice Address - Country:US
Practice Address - Phone:304-293-4431
Practice Address - Fax:304-293-3705
Is Sole Proprietor?:No
Enumeration Date:2009-08-31
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1070103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist