| NPI | 1790166296 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEAN M JENSEN Owner 918-914-3125 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: OK 1112) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant |
| 2251P0200X Physical Therapist, Pediatrics | |
| 225200000X Physical Therapy Assistant | |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2015-06-11 |
| Last Update Date | 2015-06-11 |