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General NPI Number Information
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NPI Number | 1669682720
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Entity Type | Individual
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Provider Name | STACY ANN BOCKELMAN OTR/L
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Gender | Female
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 07/06/2016
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Provider Practice Location Address
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Address Line | 4100 S DOUGLAS AVE
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City | OKLAHOMA CITY
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State | OK
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Zip | 73109-3210
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Country | US
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Telephone | 405-644-5182
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Fax |
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Provider Business Mailing Address
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Address Line | 217 N RAMBLIN OAKS DR
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City | MOORE
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State | OK
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Zip | 73160-7834
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Country | US
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Telephone | 405-799-2989
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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 | 1547
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License Number State | OK
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