Provider Demographics
NPI:1770374001
Name:LITTLEJOHN, STEPHANY LEANN (PTA)
Entity type:Individual
Prefix:
First Name:STEPHANY
Middle Name:LEANN
Last Name:LITTLEJOHN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:STEPHANY
Other - Middle Name:LEANN
Other - Last Name:RIGGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:4 QUANNA DR
Mailing Address - Street 2:
Mailing Address - City:FAIRLAND
Mailing Address - State:OK
Mailing Address - Zip Code:74343-1001
Mailing Address - Country:US
Mailing Address - Phone:918-541-8716
Mailing Address - Fax:
Practice Address - Street 1:21 E 3RD ST
Practice Address - Street 2:
Practice Address - City:GROVE
Practice Address - State:OK
Practice Address - Zip Code:74344-7034
Practice Address - Country:US
Practice Address - Phone:918-791-8789
Practice Address - Fax:877-912-0432
Is Sole Proprietor?:No
Enumeration Date:2025-05-15
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1266208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation