# 40:31 REHAB & WELLNESS, PLLC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578081634
- **Authorized official:** TARA MICHELLE OTTENBACHER OTR/L (OWNER)
- **Authorized official phone:** (580) 982-8316

## Contact information

- **Practice address:** 1805 N YORK ST STE H, MUSKOGEE, OK 74403-1442
- **Practice address phone:** (918) 912-2796
- **Practice address fax:** (918) 513-5808
- **Mailing address:** 1805 N YORK ST STE H, MUSKOGEE, OK 74403-1442
- **Mailing address phone:** (918) 912-2796
- **Mailing address fax:** (918) 513-5808

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 224Z00000X | Occupational Therapy Assistant | — | NULL | — |
| 224Z00000X | Occupational Therapy Assistant | — | — | — |
| 225X00000X | Occupational Therapist | 2138 | OK | Yes |
| 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