Individual
MRS. JESSICA SANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
12899 E 76TH ST N, 109, OWASSO, OK 74055-4021
(918) 609-6003
Mailing address
12899 E 76TH ST N, 109, OWASSO, OK 74055-4021
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
944
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100645670A
—
OK
Enumeration date
08/07/2006
Last updated
07/12/2011
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