Healthcare Provider Details

I. General information

NPI: 1134042013
Provider Name (Legal Business Name): MARY WELCH OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 CANADIAN TRAILS DR
NORMAN OK
73072-7627
US

IV. Provider business mailing address

24325 WESTERN AVE
WASHINGTON OK
73093-4527
US

V. Phone/Fax

Practice location:
  • Phone: 405-360-0606
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number5602
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: