Provider Demographics
NPI:1619099652
Name:TRUE, ROBBY RUSSELL (MHR, LADC)
Entity Type:Individual
Prefix:MR
First Name:ROBBY
Middle Name:RUSSELL
Last Name:TRUE
Suffix:
Gender:M
Credentials:MHR, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1108 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:CLAREMORE
Mailing Address - State:OK
Mailing Address - Zip Code:74017-8308
Mailing Address - Country:US
Mailing Address - Phone:918-342-9875
Mailing Address - Fax:
Practice Address - Street 1:408 E WILL ROGERS BLVD
Practice Address - Street 2:
Practice Address - City:CLAREMORE
Practice Address - State:OK
Practice Address - Zip Code:74017-7455
Practice Address - Country:US
Practice Address - Phone:918-283-1423
Practice Address - Fax:918-283-1429
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK559101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)