Basic Information
Provider Information
NPI: 1326055633
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STEELE
FirstName: JUDY
MiddleName: S
NamePrefix:  
NameSuffix:  
Credential: OT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2232 W HOUSTON ST
Address2:  
City: BROKEN ARROW
State: OK
PostalCode: 740123529
CountryCode: US
TelephoneNumber: 9182599522
FaxNumber: 9182599521
Practice Location
Address1: 2002 12TH AVE NW
Address2: STE A
City: ARDMORE
State: OK
PostalCode: 734011227
CountryCode: US
TelephoneNumber: 5802269235
FaxNumber: 5802269239
Other Information
ProviderEnumerationDate: 08/01/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X385OKY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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