Provider Demographics
NPI:1033397344
Name:CAN DO KIDS THERAPY
Entity Type:Organization
Organization Name:CAN DO KIDS THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANNA
Authorized Official - Middle Name:K
Authorized Official - Last Name:PERSUN
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:405-923-9672
Mailing Address - Street 1:14 E AYERS ST
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-3667
Mailing Address - Country:US
Mailing Address - Phone:405-923-9672
Mailing Address - Fax:180-068-0913
Practice Address - Street 1:14 E AYERS ST
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-3667
Practice Address - Country:US
Practice Address - Phone:405-923-9672
Practice Address - Fax:180-068-0913
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-08
Last Update Date:2014-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKOT866174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200128980 AMedicaid