Individual
MS. LAHOMA T ROEBUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW,LCSW,LCSW-C
Contact information
Practice address
1322 W MAIN, ANTLERS, OK 74523-1322
(580) 298-5062
(580) 298-9958
Mailing address
1322 W. MAIN, ANTLERS, OK 74523-1322
(580) 298-5062
(580) 298-9958
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
3668
OK
1041C0700X
Clinical Social Worker
11196
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200111200A
—
OK
05
—
273855
—
OR
01
—
HSZ204
MEDICARE GROUP NUMBER
OR
Enumeration date
04/01/2008
Last updated
07/06/2011
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