Healthcare Provider Details

I. General information

NPI: 1811804412
Provider Name (Legal Business Name): JANICE GREEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1818 W LINDSEY ST STE D110
NORMAN OK
73069-4172
US

IV. Provider business mailing address

3432 MOUNT MITCHELL LN
NORMAN OK
73069-3108
US

V. Phone/Fax

Practice location:
  • Phone: 405-360-5554
  • Fax: 406-360-1344
Mailing address:
  • Phone: 405-612-8677
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number3022
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: