Provider Demographics
NPI:1770123531
Name:STROKER, ROBERT B (PSYD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:B
Last Name:STROKER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10617 KETTERING DR STE 213
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-4900
Mailing Address - Country:US
Mailing Address - Phone:704-412-1107
Mailing Address - Fax:
Practice Address - Street 1:10617 KETTERING DR STE 213
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-4900
Practice Address - Country:US
Practice Address - Phone:704-412-1107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-09
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5486103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical