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General NPI Number Information
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NPI Number | 1043608813
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Entity Type | Individual
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Provider Name | ANNA ELIZABETH FOGLE MOTR/L
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Gender | Female
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Dates
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Enumeration Date | 01/02/2015
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Last Update Date | 03/31/2022
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Provider Practice Location Address
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Address Line | 1212 S AIR DEPOT BLVD STE 9
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City | OKLAHOMA CITY
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State | OK
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Zip | 73110-4860
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Country | US
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Telephone | 405-455-6868
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Fax |
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Provider Business Mailing Address
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Address Line | 3101 AERIE DR
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City | EDMOND
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State | OK
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Zip | 73013-7477
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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 | 1894
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License Number State | OK
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