MEDICARE: GUESTHOUSE THERAPEUTICS LLC

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	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1063090603
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GUESTHOUSE THERAPEUTICS LLC

Provider Business Mailing Address
First Line	:	2641 NW 34TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-7633
Country	:	US
Telephone Number	:	951-505-9485
Fax Number	:

Provider Business Practice Location Address
First Line	:	701 W SHERIDAN AVE STE 301
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73102-2402
Country	:	US
Telephone Number	:	951-505-9485
Fax Number	:

Authorized Official
Title or Position	:	OCCUPATIONAL THERAPIST
Name	:	HANNAH TYER
Credential	:
Telephone Number	:	951-505-9485

Provider Enumeration Date	:	04/01/2021
Last Update Date	:	07/17/2024

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