Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 224Z00000X | Occupational Therapy Assistant | 1509 | OK |
Y | 225XP0200X | Occupational Therapist - Pediatrics | 5528 | OK |
NPI | 1053974162 |
---|---|
Provider Name | Casey N Stephens |
First Address | Oklahoma City, OK 73165-7681 |
Second Address | Oklahoma City, OK 73165-7681 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2019 |
Last Update Date | 08/10/2021 |