Healthcare Provider Details

I. General information

NPI: 1699440172
Provider Name (Legal Business Name): ERIKA D. MILLER OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2021
Last Update Date: 09/14/2023
Certification Date: 08/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

THERAFUN LLC 1201 W. BOYD ST.
NORMAN OK
73069-4801
US

IV. Provider business mailing address

523 N. MONROE
BLANCHARD OK
73010-6011
US

V. Phone/Fax

Practice location:
  • Phone: 405-366-7898
  • Fax: 405-366-0010
Mailing address:
  • Phone: 602-769-3475
  • Fax: 405-366-0010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOTH-008583
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number5744
License Number StateOK
# 3
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number5744
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: