Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 5377 | OK |
NPI | 1013565126 |
---|---|
Provider Name | Rachel Langford |
First Address | Durant, OK 74701-8128 |
Second Address | Durant, OK 74701-2134 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2019 |
Last Update Date | 01/09/2019 |