Individual
SHAUNTA GILLS-ROBERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1016 SW 44TH ST STE 500, OKLAHOMA CITY, OK 73109-3615
(405) 605-4249
(405) 605-0255
Mailing address
PO BOX 721627, OKLAHOMA CITY, OK 73172-1627
(405) 684-3104
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
5917
OK
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200360060A
—
OK
Enumeration date
04/28/2010
Last updated
01/14/2020
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