Provider Demographics
NPI:1043061450
Name:ROBERSON, WHITNEY JUNE
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:JUNE
Last Name:ROBERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:WHITNEY
Other - Middle Name:JUNE
Other - Last Name:PEACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:907 S DETROIT AVE STE 845
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74120-4300
Mailing Address - Country:US
Mailing Address - Phone:918-232-3150
Mailing Address - Fax:
Practice Address - Street 1:907 S DETROIT AVE STE 845
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74120-4300
Practice Address - Country:US
Practice Address - Phone:918-232-3150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator