Individual
AMANDA LONGORIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1923 S UTICA AVE, TULSA, OK 74104-6520
(918) 744-2476
Mailing address
12697 E 51ST ST, TULSA, OK 74146-6236
(918) 505-3200
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1783
OK
Other
Enumeration date
06/03/2021
Last updated
06/11/2021
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