Individual
MICAH R ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
CLARA LUPER 615 N CLASSEN BLVD, OKC, OK 73106
(405) 587-0430
Mailing address
CLARA LUPER 615 N CLASSEN BLVD, OKC, OK 73106
(316) 573-8821
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
2694
KS
235Z00000X
Speech-Language Pathologist
Primary
2764
OK
Other
Enumeration date
06/21/2012
Last updated
09/15/2023
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