Provider Demographics
NPI:1932423837
Name:STRAIT, ROBERT HASKELL JR (MED)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:HASKELL
Last Name:STRAIT
Suffix:JR
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1234 W SPRINGS HWY
Mailing Address - Street 2:
Mailing Address - City:JONESVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29353-2421
Mailing Address - Country:US
Mailing Address - Phone:864-426-4676
Mailing Address - Fax:
Practice Address - Street 1:516 N PINCKNEY ST
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:SC
Practice Address - Zip Code:29379-1860
Practice Address - Country:US
Practice Address - Phone:864-426-4676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-22
Last Update Date:2010-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3481101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health