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General NPI Number Information
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NPI Number | 1457782500
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Entity Type | Individual
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Provider Name | MELISSA JONES OT
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Gender | Female
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Dates
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Enumeration Date | 11/27/2013
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Last Update Date | 01/20/2016
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Provider Practice Location Address
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Address Line | 7608 E 91ST ST
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City | TULSA
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State | OK
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Zip | 74133-6014
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Country | US
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Telephone | 918-663-0606
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Fax | 918-663-8754
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Provider Business Mailing Address
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Address Line | 14202 E 104TH ST N
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City | OWASSO
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State | OK
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Zip | 74055-4579
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Country | US
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Telephone | 307-272-2029
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 1838
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License Number State | OK
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