Provider Demographics
NPI:1073722773
Name:WOODARD, JOCELYN JARITHA (OTRL)
Entity Type:Individual
Prefix:MISS
First Name:JOCELYN
Middle Name:JARITHA
Last Name:WOODARD
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:874 BROOKWOOD DR
Mailing Address - Street 2:APT 202
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73139-4918
Mailing Address - Country:US
Mailing Address - Phone:405-412-8272
Mailing Address - Fax:
Practice Address - Street 1:4219 S WESTERN AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73109-3410
Practice Address - Country:US
Practice Address - Phone:405-644-5289
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1485225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist