Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT640 | OK |
N | 225XG0600X | Occupational Therapist - Gerontology | OT640 | OK |
N | 2251H1300X | Human Factors | OT640 | OK |
N | 225XH1300X | Human Factors | OT640 | OK |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OT640 | OK |
NPI | 1013387703 |
---|---|
Provider Name | Ms. Talitha Gloria Glosemeyer |
First Address | Muskogee, OK 74401-2275 |
Second Address | Tulsa, OK 74136-2107 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/10/2015 |
Last Update Date | 07/10/2015 |