Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 5566 | OK |
NPI | 1043885486 |
---|---|
Provider Name | Shelby Perkins |
First Address | Tulsa, OK 74135-2606 |
Second Address | Tulsa, OK 74135-2606 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2021 |
Last Update Date | 06/10/2021 |