Provider Demographics
NPI:1891013850
Name:REIMER, ROBERTA SUE (MED)
Entity Type:Individual
Prefix:MS
First Name:ROBERTA
Middle Name:SUE
Last Name:REIMER
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2712 QUANAH PARKER TRL
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-6837
Mailing Address - Country:US
Mailing Address - Phone:405-366-1816
Mailing Address - Fax:
Practice Address - Street 1:2712 QUANAH PARKER TRL
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-6837
Practice Address - Country:US
Practice Address - Phone:405-366-1816
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-13
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool