Individual
MARY ELLEN ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
1612 NW 184TH ST, EDMOND, OK 73012-0607
(405) 642-7999
(405) 562-4598
Mailing address
1612 NW 184TH ST, EDMOND, OK 73012-0607
(405) 642-7999
(405) 562-4598
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3047
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10
BEHAVIORAL HEALTH & SOCIAL SERVICE PROVIDERS
OK
Enumeration date
07/14/2008
Last updated
07/16/2015
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