Provider Demographics
NPI:1205613544
Name:KING-ELAM, DAHN (OTR/L)
Entity type:Individual
Prefix:
First Name:DAHN
Middle Name:
Last Name:KING-ELAM
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:DAHN
Other - Middle Name:
Other - Last Name:KING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR/L
Mailing Address - Street 1:1201 NE 48TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73111-5819
Mailing Address - Country:US
Mailing Address - Phone:405-587-0000
Mailing Address - Fax:
Practice Address - Street 1:1201 NE 48TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73111-5819
Practice Address - Country:US
Practice Address - Phone:405-587-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK530225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist