Individual
ROLAND V TABB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BHRS
Contact information
Practice address
625 NW 13TH ST, OKLAHOMA CITY, OK 73103-2239
(405) 601-2307
(405) 601-3317
Mailing address
625 NW 13TH ST, OKLAHOMA CITY, OK 73103-2239
(405) 601-2307
(405) 601-3317
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200077440
—
OK
Enumeration date
06/02/2008
Last updated
06/02/2008
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