Provider Demographics
NPI:1790884682
Name:MCCALEB, GAYLE ANN (OTR/L)
Entity Type:Individual
Prefix:
First Name:GAYLE
Middle Name:ANN
Last Name:MCCALEB
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 1:10625 S 69TH EAST AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-7151
Mailing Address - Country:US
Mailing Address - Phone:918-298-8695
Mailing Address - Fax:
Practice Address - Street 1:11009 S MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-7357
Practice Address - Country:US
Practice Address - Phone:918-369-8030
Practice Address - Fax:918-369-8030
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKOT23174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty