Provider Demographics
NPI:1669439576
Name:RHINEHART, LISA ANN (OTR/L, CHT)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:ANN
Last Name:RHINEHART
Suffix:
Gender:F
Credentials:OTR/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 E. 15TH ST.
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74120
Mailing Address - Country:US
Mailing Address - Phone:918-599-0440
Mailing Address - Fax:918-599-7774
Practice Address - Street 1:1310 E. 15TH ST.
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74120
Practice Address - Country:US
Practice Address - Phone:918-599-0440
Practice Address - Fax:918-599-7774
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2012-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKOT347225X00000X
OKOT397225XH1200X
OKCHT951000363225XH1200X
OK397225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
376576Medicare ID - Type Unspecified