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General NPI Number Information
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NPI Number | 1912054198
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Entity Type | Individual
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Provider Name | MS. PAULA M LEWIS
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Gender | Female
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 10948A NW EXPRESSWAY ST
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City | YUKON
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State | OK
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Zip | 73099-8214
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Country | US
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Telephone | 405-373-3122
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Fax | 405-373-3443
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Provider Business Mailing Address
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Address Line | 3613 NW 68TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73116-2015
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Country | US
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Telephone | 405-641-8633
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Fax | 405-373-3443
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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 | 645
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License Number State | OK
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