Provider Demographics
NPI:1700411162
Name:PEREZ, ANA HERLINDA (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:ANA
Middle Name:HERLINDA
Last Name:PEREZ
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1732 SW 32ND ST
Mailing Address - Street 2:
Mailing Address - City:MOORE
Mailing Address - State:OK
Mailing Address - Zip Code:73160-2932
Mailing Address - Country:US
Mailing Address - Phone:405-550-8488
Mailing Address - Fax:
Practice Address - Street 1:1776 E ROBINSON ST
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-7442
Practice Address - Country:US
Practice Address - Phone:405-360-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-05
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK991224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant