Provider Demographics
NPI:1770506180
Name:BODEHARRISON, OLUKANYIN M (MA)
Entity type:Individual
Prefix:MS
First Name:OLUKANYIN
Middle Name:M
Last Name:BODEHARRISON
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Gender:F
Credentials:MA
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Mailing Address - Street 1:3542 DELAWARE ST
Mailing Address - Street 2:
Mailing Address - City:MUSKOGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74403-4940
Mailing Address - Country:US
Mailing Address - Phone:918-680-3666
Mailing Address - Fax:918-781-8540
Practice Address - Street 1:1011 HONOR HEIGHTS DR
Practice Address - Street 2:11A
Practice Address - City:MUSKOGEE
Practice Address - State:OK
Practice Address - Zip Code:74401-1318
Practice Address - Country:US
Practice Address - Phone:918-680-3666
Practice Address - Fax:918-781-8540
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255R0406XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistRehabilitation, Blind