Provider Demographics
NPI:1780559146
Name:CARTER, LANEY ANN
Entity type:Individual
Prefix:
First Name:LANEY
Middle Name:ANN
Last Name:CARTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 SOUTH FIRST STREET
Mailing Address - Street 2:
Mailing Address - City:TRYON
Mailing Address - State:OK
Mailing Address - Zip Code:74875
Mailing Address - Country:US
Mailing Address - Phone:405-714-2737
Mailing Address - Fax:
Practice Address - Street 1:301 S DUCK ST
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74074-3249
Practice Address - Country:US
Practice Address - Phone:405-377-8255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-07
Last Update Date:2025-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2739224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant