Healthcare Provider Details

I. General information

NPI: 1215093372
Provider Name (Legal Business Name): ABOVE & BEYOND OCCUPATIONAL THERAPY, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

751 W 67TH ST
TULSA OK
74132-1807
US

IV. Provider business mailing address

751 W 67TH ST
TULSA OK
74132-1807
US

V. Phone/Fax

Practice location:
  • Phone: 918-446-4068
  • Fax: 918-446-4068
Mailing address:
  • Phone: 918-446-4068
  • Fax: 918-446-4068

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT73
License Number StateOK

VIII. Authorized Official

Name: ANNE ELIZABETH MCCOY
Title or Position: PRESIDENT
Credential: O.T.
Phone: 918-446-4068