Individual
ROBERTA HEATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BHRS
Contact information
Practice address
110 N 4TH ST, PONCA CITY, OK 74601-4527
(918) 273-1841
Mailing address
110 N 4TH ST, PONCA CITY, OK 74601-4527
(580) 977-8525
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
1221
OK
Other
Enumeration date
08/28/2012
Last updated
03/11/2019
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