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General NPI Number Information
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NPI Number | 1558607804
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Entity Type | Individual
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Provider Name | KARI DAWN TANNER MOTR/L
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Gender | Female
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Dates
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Enumeration Date | 12/13/2012
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Last Update Date | 02/05/2025
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Provider Practice Location Address
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Address Line | 310 2ND AVE SW
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City | MIAMI
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State | OK
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Zip | 74354-6743
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Country | US
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Telephone | 918-540-7736
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Fax | 918-540-7739
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Provider Business Mailing Address
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Address Line | 16412 S 4415 RD
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City | BLUEJACKET
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State | OK
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Zip | 74333-4341
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Country | US
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Telephone | 918-704-3460
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 1072
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 6011
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License Number State | OK
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