MEDICARE: KATIE FLETCHER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	224Z00000X	Occupational Therapy Assistant	2467	OK

General Provider Information

NPI Number	:	1053244574
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATIE FLETCHER

Provider Business Mailing Address
First Line	:	1800 W ALBANY DR APT 1023
Second Line	:
City	:	BROKEN ARROW
State	:	OK
Zip	:	74012-5832
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3701 N MARTIN LUTHER KING JR BLVD
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74106-6450
Country	:	US
Telephone Number	:	918-425-3583
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/04/2026
Last Update Date	:	06/04/2026

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Directions to “ KATIE FLETCHER ” Practice Location

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