Provider Demographics
NPI:1093928574
Name:CONNER, ROXANNA RAE (BS, CM-D,BHRS)
Entity Type:Individual
Prefix:MRS
First Name:ROXANNA
Middle Name:RAE
Last Name:CONNER
Suffix:
Gender:F
Credentials:BS, CM-D,BHRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4436 NW 50TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-2212
Mailing Address - Country:US
Mailing Address - Phone:405-272-2733
Mailing Address - Fax:405-858-2810
Practice Address - Street 1:2322 W 7TH AVE
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74074-1903
Practice Address - Country:US
Practice Address - Phone:405-372-1131
Practice Address - Fax:405-372-3632
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor