Most Relevant Information
Provider Data
| NPI Number: | 1003342940 |
| Provider Name: | ROBERT B HAGBERG LICSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | ISW00659 |
Most Important Dates
| Enumeration Date: | 05/11/2017 |
| Last Updated: | 05/11/2017 |
Provider Practice Location
153 SUMMER ST
PROVIDENCE
RI
029034011
Practice Location Phone/Fax
| Phone: | 4012764300 |
| Fax: | 0413313285 |
Provider Mailing Location
153 SUMMER ST
PROVIDENCE
RI
029034011
Provider Mailing Phone/Fax
| Phone: | 4012764300 |
| Fax: | 0413313285 |