Provider Information for 1124127725
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Ms. ROBE LEW MOURER LCSW
Sex: Female
NPI: 1124127725
Last Updated: 2018-07-17
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1124127725 | ||||||||
| Enumeration Date | 2006-09-21 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 624 E BASELINE RD TIPTON, OK 73570-6001 United States Phone: 918-574-1169 | Fax: | ||||||||
| Primary Practice Address | 624 E BASELINE RD TIPTON, OK 73570 United States Phone: 918-574-1169 | Fax: | ||||||||
| Secondary Practice Address(es) | 4045 NW 64TH ST | ||||||||
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