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DR. ROBERT LAKE CONDER PSY.D.

Clinical Neuropsychologist

Raleigh, North Carolina

Provider NPI: 1891892337

Provider Information:
DR. ROBERT LAKE CONDER PSY.D.
Gender: M
Not Sole Proprietor

Practice Location:
1540 SUNDAY DR SUITE 200 RALEIGH, NC 27607 US
Tel: 919-859-9040  Fax: 919-859-9030

Business Mailing Address:
1540 SUNDAY DR SUITE 200 RALEIGH, NC 27607 US
Tel: 919-859-9040  Fax: 919-859-9030

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
NC1397

Other Provider Identifiers:

IssuerNumberStateType
BLUE CROSS0324FNC01
6000627NC05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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