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General NPI Number Information
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NPI Number | 1033386925
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Entity Type | Individual
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Provider Name | SUMMER TROOK OTR/L
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Gender | Female
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Dates
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Enumeration Date | 05/11/2008
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Last Update Date | 03/18/2010
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Provider Practice Location Address
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Address Line | 1724 S HARVARD AVE
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City | TULSA
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State | OK
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Zip | 74112-6826
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Country | US
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Telephone | 918-250-7093
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Fax | 918-250-9976
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Provider Business Mailing Address
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Address Line | 6410 E 165TH ST S
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City | BIXBY
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State | OK
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Zip | 74008-3825
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 112664
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 1489
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License Number State | OK
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