Healthcare Provider Details

I. General information

NPI: 1386644805
Provider Name (Legal Business Name): SUZANNE MARY MAROLF OTR/L CHT
Entity Type: Individual
Gender: Female
Sole Proprietor: X

Provider Other Name: SUZANNE MARY SCHULTZ

II. Dates (important events)

Enumeration Date: 07/27/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4157 S HARVARD AVE SUITE 117
TULSA OK
74135-2631
US

IV. Provider business mailing address

4157 S HARVARD AVE SUITE 117
TULSA OK
74135-2631
US

V. Phone/Fax

Practice location:
  • Phone: 918-712-7868
  • Fax: 918-749-2901
Mailing address:
  • Phone: 918-712-7868
  • Fax: 918-749-2901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License NumberOT436
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT436
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: