Provider Demographics
NPI:1265935084
Name:LANE, DELANEY (OTR)
Entity type:Individual
Prefix:
First Name:DELANEY
Middle Name:
Last Name:LANE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:DELANEY
Other - Middle Name:
Other - Last Name:RIVES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10700 S MAY AVE APT 423
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73170-2579
Mailing Address - Country:US
Mailing Address - Phone:432-438-1539
Mailing Address - Fax:
Practice Address - Street 1:9221 HARMONY DR
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73130-6255
Practice Address - Country:US
Practice Address - Phone:405-869-0700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-18
Last Update Date:2018-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2180225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist