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NPI Code Detail

MEDICARE: SKYLAR DANIELLE FORD

MEDICARE: SKYLAR DANIELLE FORD
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
1224Z00000XOccupational Therapy Assistant1716OK

General Provider Information

NPI Number : 1144717190
Entity Type Code : Individual
Provider Name (Legal Business Name) : SKYLAR DANIELLE FORD
Provider Business Mailing Address
First Line : PO BOX 60189
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73146-0189
Country : US
Telephone Number : 918-397-2043
Fax Number :
Provider Business Practice Location Address
First Line : 5301 N BROOKLINE AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73112-3516
Country : US
Telephone Number : 918-397-2043
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/16/2018
Last Update Date : 04/16/2018

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Directions to “ SKYLAR DANIELLE FORD ” Practice Location

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