Provider Demographics
NPI:1710039060
Name:VOPAT, MISTY S (OTR)
Entity Type:Individual
Prefix:MS
First Name:MISTY
Middle Name:S
Last Name:VOPAT
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5009 E 86TH PL
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-2919
Mailing Address - Country:US
Mailing Address - Phone:918-794-2865
Mailing Address - Fax:
Practice Address - Street 1:5009 E 86TH PL
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-2919
Practice Address - Country:US
Practice Address - Phone:918-794-2865
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2010-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17-01655225X00000X
OK1532225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist