Provider Demographics
NPI:1972162741
Name:CARDER, ROBERT DEE (BSHS)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:DEE
Last Name:CARDER
Suffix:
Gender:M
Credentials:BSHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11942 COUNTY ROAD 106
Mailing Address - Street 2:
Mailing Address - City:KENTON
Mailing Address - State:OH
Mailing Address - Zip Code:43326-9498
Mailing Address - Country:US
Mailing Address - Phone:567-674-0495
Mailing Address - Fax:
Practice Address - Street 1:416 S MAIN ST
Practice Address - Street 2:
Practice Address - City:KENTON
Practice Address - State:OH
Practice Address - Zip Code:43326-1947
Practice Address - Country:US
Practice Address - Phone:567-674-0495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-06
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor