Provider Demographics
NPI:1952530925
Name:STOCKMAN, ROBERT DONALD (PHD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:DONALD
Last Name:STOCKMAN
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 1:16412 E GLENBROOK BLVD
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN HILLS
Mailing Address - State:AZ
Mailing Address - Zip Code:85268-2243
Mailing Address - Country:US
Mailing Address - Phone:480-323-0485
Mailing Address - Fax:
Practice Address - Street 1:16412 E GLENBROOK BLVD
Practice Address - Street 2:
Practice Address - City:FOUNTAIN HILLS
Practice Address - State:AZ
Practice Address - Zip Code:85268-2243
Practice Address - Country:US
Practice Address - Phone:480-323-0485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-10
Last Update Date:2009-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4033103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist