Provider Demographics
NPI:1578500781
Name:RUBINO-WATKINS, MARIA FRANCESCA (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:FRANCESCA
Last Name:RUBINO-WATKINS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 E. 9TH STREET
Mailing Address - Street 2:STE 5
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034
Mailing Address - Country:US
Mailing Address - Phone:405-532-4023
Mailing Address - Fax:405-513-8492
Practice Address - Street 1:1300 E. 9TH STREET
Practice Address - Street 2:STE 5
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034
Practice Address - Country:US
Practice Address - Phone:405-532-4023
Practice Address - Fax:405-513-8492
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1014103G00000X, 103TB0200X, 103TC2200X, 103TH0100X, 103TM1800X, 103TR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200078530AMedicaid
OK11561399Medicare UPIN
OK200078530AMedicaid