Individual
MYRA MARTHA DEMISSIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2401 NW 23RD ST STE 1C, OKLAHOMA CITY, OK 73107-2420
(405) 355-3239
Mailing address
928 NE 17TH ST, OKLAHOMA CITY, OK 73105-8408
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
0119010519
VA
225X00000X
Occupational Therapist
07952
MD
225X00000X
Occupational Therapist
17-04253
KS
225X00000X
Occupational Therapist
Primary
5664
OK
225X00000X
Occupational Therapist
OT010001546
DC
Other
Enumeration date
01/20/2018
Last updated
05/06/2025
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