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NPI Code Detail

MEDICARE: REBECCA DANIELLE ANDERSON OTR/L

MEDICARE: REBECCA DANIELLE ANDERSON OTR/L
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
1225X00000XOccupational Therapist5354OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15354OTHEROKOT LICENSE

General Provider Information

NPI Number : 1124616693
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA DANIELLE ANDERSON OTR/L
Provider Business Mailing Address
First Line : 4981 E 26TH ST
Second Line :
City : TULSA
State : OK
Zip : 74114-4917
Country : US
Telephone Number : 918-261-5457
Fax Number :
Provider Business Practice Location Address
First Line : 10020 E 91ST ST
Second Line :
City : TULSA
State : OK
Zip : 74133-5835
Country : US
Telephone Number : 918-940-8801
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2021
Last Update Date : 01/09/2021

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Directions to “ REBECCA DANIELLE ANDERSON OTR/L” Practice Location

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