Healthcare Provider Details

I. General information

NPI: 1861819005
Provider Name (Legal Business Name): JESSICA A. ARENT OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2014
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 ANDERSON AVE
ALTUS OK
73521-7475
US

IV. Provider business mailing address

19 ANDERSON AVE
ALTUS OK
73521-7475
US

V. Phone/Fax

Practice location:
  • Phone: 402-209-0988
  • Fax:
Mailing address:
  • Phone: 402-209-0988
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number072976
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number1806
License Number StateNE
# 3
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number6155
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: