Provider Demographics
NPI:1114270782
Name:NAIDU, SUBASHNI (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:SUBASHNI
Middle Name:
Last Name:NAIDU
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MISS
Other - First Name:SUBASHNI
Other - Middle Name:
Other - Last Name:PILLAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:11701 MILL HOLLOW CT
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73131-7526
Mailing Address - Country:US
Mailing Address - Phone:405-203-5940
Mailing Address - Fax:
Practice Address - Street 1:11701 MILL HOLLOW CT
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73131-7526
Practice Address - Country:US
Practice Address - Phone:405-203-5940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-19
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKOT 983172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker