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Organization
40:31 REHAB & WELLNESS, PLLC.
Active
Organization
40:31 REHAB & WELLNESS, PLLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARA MICHELLE OTTENBACHER OTR/L (OWNER)
(580) 982-8316
Entity
Organization
Contact information
Practice address
1805 N YORK ST STE H, MUSKOGEE, OK 74403-1442
(918) 912-2796
(918) 513-5808
Mailing address
1805 N YORK ST STE H, MUSKOGEE, OK 74403-1442
(918) 912-2796
(918) 513-5808
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
—
NULL
224Z00000X
Occupational Therapy Assistant
—
—
225X00000X
Occupational Therapist
Primary
2138
OK
225XM0800X
Mental Health Occupational Therapist
—
NULL
225XM0800X
Mental Health Occupational Therapist
—
—
2355S0801X
Speech-Language Assistant
—
NULL
2355S0801X
Speech-Language Assistant
—
—
235Z00000X
Speech-Language Pathologist
—
NULL
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
09/08/2017
Last updated
09/10/2026
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