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Individual

MARIAM GATES-ROBIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1985 W 33RD ST, EDMOND, OK 73013
(405) 625-0862
(405) 285-6814
Mailing address
1985 W 33RD ST, EDMOND, OK 73013-3875
(405) 625-0862
(405) 285-6814

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6319
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1306245378
OK
Enumeration date
08/15/2014
Last updated
05/24/2018
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