Roberson, Gwendolyn Earle
Roberson, Gwendolyn Earle is an sole proprietor health care provider with primary practice located at 1120 Route 73 Ste 300 , Mount Laurel NJ 08054-5113. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Behavioral Health & Social Service Providers / Psychologist. Allopathic & Osteopathic Physicians / Psychiatry is her primary health care specialty. Roberson, Gwendolyn Earle can be contacted via phone (856) 930-4097.Contact Information
Primary practice address
1120 Route 73 Ste 300
Mount Laurel NJ 08054-5113
Phone: (856) 930-4097
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 74047 | Arizona |
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 7770041-1205 | Utah |
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 70664 | Minnesota |
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 7770041-1205 | Utah |
Profile Details
| NPI number | 1558504191 |
|---|---|
| LBN Legal business name | Roberson, Gwendolyn Earle |
| Credentials | MD, MA |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 13th, 2009 |
| Last updated | Jul 5th, 2024 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1558504191 | NPPES |
| Utah | MEDICAID | 1558504191 |
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