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Individual

MARLENE S SNOW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L, MS, SCLV, CDE

Contact information

Practice address
18433 SIERRA LN, NEWALLA, OK 74857-8449
(405) 391-2115
Mailing address
18433 SIERRA LN, NEWALLA, OK 74857-8449

Taxonomy

Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
21801092
OK
171W00000X
Contractor
OT802
OK
225X00000X
Occupational Therapist
225XE0001X
Environmental Modification Occupational Therapist
802
OK
225XL0004X
Low Vision Occupational Therapist
Primary
802
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200051810B
OK
01
21801092
NATIONAL CERTIFICATION BOARD FOR DIABETES EDUCATORS
Enumeration date
01/25/2007
Last updated
02/03/2020
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