MEDICARE: MS. LOVER MAE ROBINSON LPC, LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	2795	OK
2	106H00000X	Marriage & Family Therapist	789	OK

General Provider Information

NPI Number	:	1508004789
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LOVER MAE ROBINSON LPC, LMFT

Provider Business Mailing Address
First Line	:	6334 S. MADISON PLACE
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74136-1387
Country	:	US
Telephone Number	:	918-749-2723
Fax Number	:	918-495-7154

Provider Business Practice Location Address
First Line	:	6334 S. MADISON PLACE
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74136-1387
Country	:	US
Telephone Number	:	918-749-2723
Fax Number	:	918-495-7154

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/27/2009
Last Update Date	:	01/27/2009

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