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General NPI Number Information
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NPI Number | 1659271468
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Entity Type | Individual
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Provider Name | BRIANNA CRIS WISE
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Gender | Female
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Dates
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Enumeration Date | 11/06/2026
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Last Update Date | 11/06/2026
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Provider Practice Location Address
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Address Line | 4229 ROYAL AVE STE 200
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City | OKLAHOMA CITY
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State | OK
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Zip | 73108-2058
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Country | US
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Telephone | 787-340-2531
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Fax |
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Provider Business Mailing Address
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Address Line | 10209 HOLLYHEAD WAY
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City | YUKON
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State | OK
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Zip | 73099-7575
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Country | US
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Telephone | 417-699-9423
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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 |
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License Number State | OK
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