Healthcare Provider Details

I. General information

NPI: 1154953198
Provider Name (Legal Business Name): JILLIAN GARRETT OT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2020
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3149 N HIGHWAY 81
DUNCAN OK
73533-9283
US

IV. Provider business mailing address

3149 N HIGHWAY 81
DUNCAN OK
73533-9283
US

V. Phone/Fax

Practice location:
  • Phone: 580-359-0596
  • Fax: 580-359-0640
Mailing address:
  • Phone: 580-359-0596
  • Fax: 580-359-0640

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number5358
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: