Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 2104 | OK |
Y | 225XP0200X | Occupational Therapist - Pediatrics | 2104 | OK |
NPI | 1376215145 |
---|---|
Provider Name | Abbey Elizabeth Bandeh |
First Address | Tulsa, OK 74105-2452 |
Second Address | Tulsa, OK 74105-2452 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2021 |
Last Update Date | 30/09/2021 |