Provider Demographics
NPI:1861406068
Name:ROBERTSON, ELEANOR TERHUNE (PHD)
Entity type:Individual
Prefix:DR
First Name:ELEANOR
Middle Name:TERHUNE
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13791 BLUFF VILLAS CT
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-1941
Mailing Address - Country:US
Mailing Address - Phone:210-491-4415
Mailing Address - Fax:
Practice Address - Street 1:13791 BLUFF VILLAS CT
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-1941
Practice Address - Country:US
Practice Address - Phone:210-491-4415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2-1943103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling