Healthcare Provider Details

I. General information

NPI: 1689592875
Provider Name (Legal Business Name): ALLISON STALEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1445 HEALTH CENTER PKWY
YUKON OK
73099-6492
US

IV. Provider business mailing address

13300 BIG CEDAR TRL
YUKON OK
73099-8175
US

V. Phone/Fax

Practice location:
  • Phone: 405-578-9770
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number6505
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: