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General NPI Number Information
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NPI Number | 1861389009
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Entity Type | Individual
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Provider Name | LYDIA AMEND OTR/L
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Gender | Female
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Dates
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Enumeration Date | 06/20/2025
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Last Update Date | 06/20/2025
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Provider Practice Location Address
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Address Line | 13330 S MEMORIAL DR STE 1AND2
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City | BIXBY
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State | OK
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Zip | 74008-3119
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Country | US
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Telephone | 918-943-5084
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Fax | 855-940-1855
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Provider Business Mailing Address
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Address Line | 7738 N OWASSO EXPY
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City | OWASSO
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State | OK
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Zip | 74055-3338
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Country | US
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Telephone | 918-928-4255
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Fax | 918-928-4258
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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 | 6119
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License Number State | OK
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