Provider Demographics
NPI:1790734358
Name:QUALITY OCCUPATIONAL THERAPY
Entity Type:Organization
Organization Name:QUALITY OCCUPATIONAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OTR/ OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:HOLLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:405-610-3048
Mailing Address - Street 1:PO BOX 197
Mailing Address - Street 2:
Mailing Address - City:HARRAH
Mailing Address - State:OK
Mailing Address - Zip Code:73045-0197
Mailing Address - Country:US
Mailing Address - Phone:405-610-3048
Mailing Address - Fax:405-610-3049
Practice Address - Street 1:8827 E RENO AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73110-7732
Practice Address - Country:US
Practice Address - Phone:405-610-3048
Practice Address - Fax:405-610-3049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3570225100000X
OKOT999225X00000X
OK2631235Z00000X
OK3070235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty