Provider Demographics
NPI:1841592334
Name:LAING, ROBERT D
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:D
Last Name:LAING
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4405 S PRAIRIE ROAD
Mailing Address - Street 2:
Mailing Address - City:TISHOMINGO
Mailing Address - State:OK
Mailing Address - Zip Code:73460
Mailing Address - Country:US
Mailing Address - Phone:580-257-0356
Mailing Address - Fax:580-371-3688
Practice Address - Street 1:4405 S PRAIRIE RD
Practice Address - Street 2:
Practice Address - City:TISHOMINGO
Practice Address - State:OK
Practice Address - Zip Code:73460-4279
Practice Address - Country:US
Practice Address - Phone:580-257-0356
Practice Address - Fax:580-371-3688
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-03
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)