Healthcare Provider Details

I. General information

NPI: 1801707666
Provider Name (Legal Business Name): PURPOSE PEDIATRIC THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9008 N 77TH EAST AVE
OWASSO OK
74055-5623
US

IV. Provider business mailing address

9008 N 77TH EAST AVE
OWASSO OK
74055-5623
US

V. Phone/Fax

Practice location:
  • Phone: 405-714-8001
  • Fax:
Mailing address:
  • Phone: 405-714-8001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. MACY ANN CARROLL
Title or Position: OCCUPATIONAL THERAPIST
Credential: OTD, OTR/L
Phone: 405-714-8001