Provider Demographics
NPI:1376969089
Name:ROBBS, TERA LENAY
Entity Type:Individual
Prefix:
First Name:TERA
Middle Name:LENAY
Last Name:ROBBS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1822 N PERKINS RD
Mailing Address - Street 2:APT. 335
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74075-3100
Mailing Address - Country:US
Mailing Address - Phone:720-308-7077
Mailing Address - Fax:
Practice Address - Street 1:1822 N PERKINS RD
Practice Address - Street 2:APT. 335
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74075-3100
Practice Address - Country:US
Practice Address - Phone:720-308-7077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-05
Last Update Date:2014-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator