Individual
EMILY JORDAN ERNST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
4908 S SHERIDAN RD, TULSA, OK 74145-5712
(918) 984-9153
Mailing address
4908 S SHERIDAN RD, TULSA, OK 74145-5712
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
5523
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5523
OKLAHOMA STATE MEDICAL BOARD
OK
Enumeration date
09/30/2020
Last updated
11/09/2020
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