Provider Demographics
NPI:1245463991
Name:TOTAL POSS-ABILITIES, PLLC
Entity type:Organization
Organization Name:TOTAL POSS-ABILITIES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MOTR/L
Authorized Official - Phone:405-285-1828
Mailing Address - Street 1:2917 NW 156TH ST
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-2101
Mailing Address - Country:US
Mailing Address - Phone:405-285-1828
Mailing Address - Fax:405-607-4495
Practice Address - Street 1:2917 NW 156TH ST
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-2101
Practice Address - Country:US
Practice Address - Phone:405-285-1828
Practice Address - Fax:405-607-4495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-28
Last Update Date:2017-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKOK1522225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200258040AMedicaid