MEDICARE: REECA ANN YOUNG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	224Z00000X	Occupational Therapy Assistant	38	OK

General Provider Information

NPI Number	:	1083299838
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REECA ANN YOUNG

Provider Business Mailing Address
First Line	:	8309 NW 109TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73162-3006
Country	:	US
Telephone Number	:	405-503-9733
Fax Number	:

Provider Business Practice Location Address
First Line	:	5300 N MERIDIAN AVE STE 9A
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-2137
Country	:	US
Telephone Number	:	405-410-8814
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/12/2021
Last Update Date	:	03/12/2021

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Directions to “ REECA ANN YOUNG ” Practice Location

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