Healthcare Provider Details

I. General information

NPI: 1336796242
Provider Name (Legal Business Name): FOUNDATIONS THERAPY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2019
Last Update Date: 02/16/2026
Certification Date: 02/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3903 N HARRISON ST
SHAWNEE OK
74804-1426
US

IV. Provider business mailing address

3903 N HARRISON ST
SHAWNEE OK
74804-1426
US

V. Phone/Fax

Practice location:
  • Phone: 405-585-2971
  • Fax: 405-585-2983
Mailing address:
  • Phone: 405-585-2971
  • Fax: 405-585-2983

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSIAH A HADSALL
Title or Position: OWNER
Credential: OTR/L
Phone: 405-585-2971