Provider Demographics
NPI:1134260805
Name:DELOZIER, ROBERT LEE (LPC)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:LEE
Last Name:DELOZIER
Suffix:
Gender:M
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:PO BOX 696
Mailing Address - Street 2:
Mailing Address - City:SAND SPRINGS
Mailing Address - State:OK
Mailing Address - Zip Code:74063-0696
Mailing Address - Country:US
Mailing Address - Phone:918-744-2532
Mailing Address - Fax:918-744-3074
Practice Address - Street 1:1923 S UTICA AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-6520
Practice Address - Country:US
Practice Address - Phone:918-744-2532
Practice Address - Fax:918-744-3074
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2015-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1360101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional