Provider Demographics
NPI:1356512669
Name:FIKE, STEPHANIE KAY (OTR/L)
Entity type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:KAY
Last Name:FIKE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MS
Other - First Name:STEPHANIE
Other - Middle Name:KAY
Other - Last Name:ROGERS-FIKE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR/L
Mailing Address - Street 1:5300 N INDEPENDENCE AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-5550
Mailing Address - Country:US
Mailing Address - Phone:405-945-4500
Mailing Address - Fax:405-945-4501
Practice Address - Street 1:5300 N INDEPENDENCE AVE STE 100
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-5550
Practice Address - Country:US
Practice Address - Phone:405-945-4500
Practice Address - Fax:405-945-4501
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-13
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK465225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist