Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XG0600X | Occupational Therapist - Gerontology | OC001264L | PA |
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OC001264L | PA |
NPI | 1376926287 |
---|---|
Provider Name | Laura H. Stevens |
First Address | Guymon, OK 73942-3371 |
Second Address | Guymon, OK 73942-3371 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2015 |
Last Update Date | 09/07/2015 |