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General NPI Number Information
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NPI Number | 1184830119
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Entity Type | Individual
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Provider Name | CRAIG BRUCE ROBISON LPC,LMFT
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Gender | Male
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 03/19/2009
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Provider Practice Location Address
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Address Line | 3035 NW 63RD ST 202
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City | OKLAHOMA CITY
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State | OK
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Zip | 73116-3632
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Country | US
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Telephone | 405-747-6413
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Fax |
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Provider Business Mailing Address
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Address Line | 3035 NW 63RD ST 202
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City | OKLAHOMA CITY
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State | OK
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Zip | 73116-3632
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Country | US
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Telephone | 405-747-6413
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC 118
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LMFT 053
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License Number State | OK
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