Individual
AMY DENISE ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
3817 W DALLAS ST, BROKEN ARROW, OK 74012-4539
(918) 845-1200
(918) 398-9314
Mailing address
3817 W DALLAS ST, BROKEN ARROW, OK 74012-4539
(918) 845-1200
(918) 398-9314
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT 800
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100639960B
—
OK
Enumeration date
07/29/2005
Last updated
10/13/2023
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