Provider Demographics
NPI:1922341866
Name:TITTLE, ROBYN GENE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:ROBYN
Middle Name:GENE
Last Name:TITTLE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14494 S BIRCH ST
Mailing Address - Street 2:
Mailing Address - City:GLENPOOL
Mailing Address - State:OK
Mailing Address - Zip Code:74033-3531
Mailing Address - Country:US
Mailing Address - Phone:918-629-3262
Mailing Address - Fax:
Practice Address - Street 1:14494 S BIRCH ST
Practice Address - Street 2:
Practice Address - City:GLENPOOL
Practice Address - State:OK
Practice Address - Zip Code:74033-3531
Practice Address - Country:US
Practice Address - Phone:918-629-3262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-28
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3608101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional