Provider Demographics
NPI:1407147499
Name:ADMIRE, AVA YVONNE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:AVA
Middle Name:YVONNE
Last Name:ADMIRE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7028 E 99TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-5939
Mailing Address - Country:US
Mailing Address - Phone:918-760-8180
Mailing Address - Fax:
Practice Address - Street 1:7028 E 99TH ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-5939
Practice Address - Country:US
Practice Address - Phone:918-760-8180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-25
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKOT125225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist