Provider Demographics
NPI:1255385407
Name:MILHAN, LISA RENEE (OT)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:RENEE
Last Name:MILHAN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:RENEE
Other - Last Name:ZURMEHLY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10001 S WESTERN AVE
Mailing Address - Street 2:204
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73139-2997
Mailing Address - Country:US
Mailing Address - Phone:405-691-5434
Mailing Address - Fax:405-692-3703
Practice Address - Street 1:10001 S WESTERN AVE
Practice Address - Street 2:204
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-2997
Practice Address - Country:US
Practice Address - Phone:405-691-5434
Practice Address - Fax:405-692-3703
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2010-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1058225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200083620AMedicaid
OK200083620AMedicaid
OK370203Medicare Oscar/Certification