Provider Demographics
NPI:1053442517
Name:REDICK, ALLISON GAYLE (OT)
Entity Type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:GAYLE
Last Name:REDICK
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 W WILL ROGERS BLVD
Mailing Address - Street 2:
Mailing Address - City:CLAREMORE
Mailing Address - State:OK
Mailing Address - Zip Code:74017-5421
Mailing Address - Country:US
Mailing Address - Phone:918-342-3800
Mailing Address - Fax:918-342-3900
Practice Address - Street 1:1810 N SIOUX AVE STE C
Practice Address - Street 2:
Practice Address - City:CLAREMORE
Practice Address - State:OK
Practice Address - Zip Code:74017-3134
Practice Address - Country:US
Practice Address - Phone:918-341-3434
Practice Address - Fax:918-341-8687
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK833174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist