Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT512 | OK |
NPI | 1003883190 |
---|---|
Provider Name | Ms. Deanna Hewett Elias |
First Address | Norman, OK 73072-3353 |
Second Address | Norman, OK 73072-3353 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2006 |
Last Update Date | 08/07/2007 |