Individual
JILL ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS, CADC
Contact information
Practice address
69999 E 152 RD, WYANDOTTE, OK 74370-2224
(918) 541-5962
Mailing address
69999 E 152 RD, WYANDOTTE, OK 74370-2224
(918) 541-5962
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
321
OK
Other
Enumeration date
06/20/2007
Last updated
06/30/2009
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