Basic Information
| Provider Information | |||||||||
| NPI: | 1801988712 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NESTHEIDE | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | R | ||||||||
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| Credential: | PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3333 BURNET AVE | ||||||||
| Address2: | ML 5021 | ||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452293039 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5136364225 | ||||||||
| FaxNumber: | 5136362511 | ||||||||
| Practice Location | |||||||||
| Address1: | 10450 NEW HAVEN RD | ||||||||
| Address2: | ML 6008 | ||||||||
| City: | HARRISON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 45030 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5136366500 | ||||||||
| FaxNumber: | 5136366534 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/28/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | 4197 | OH | Y | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.