Individual
LORI HERAUF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3027 S NEW HAVEN AVE, TULSA, OK 74114-6131
(918) 746-7575
Mailing address
3027 S NEW HAVEN AVE, TULSA, OK 74114-6131
(918) 746-7575
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1066
OK
Other
Enumeration date
08/17/2016
Last updated
08/17/2016
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