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NPI Code Detail

MEDICARE: AMANDA TEAGUE OTR/L

MEDICARE: AMANDA TEAGUE OTR/L
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
1225X00000XOccupational Therapist1714OK

General Provider Information

NPI Number : 1982094918
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA TEAGUE OTR/L
Provider Business Mailing Address
First Line : 8808 N 144TH EAST AVE
Second Line :
City : OWASSO
State : OK
Zip : 74055-2667
Country : US
Telephone Number : 405-496-9698
Fax Number :
Provider Business Practice Location Address
First Line : 3015 E SKELLY DR STE 395
Second Line :
City : TULSA
State : OK
Zip : 74105-6348
Country : US
Telephone Number : 918-764-8378
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2015
Last Update Date : 08/04/2025

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Directions to “ AMANDA TEAGUE OTR/L” Practice Location

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