Individual
JANE STORM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1605 S EUCALYPTUS AVE STE 200, BROKEN ARROW, OK 74012-5996
(918) 608-1212
(918) 289-2606
Mailing address
1605 S EUCALYPTUS AVE STE 200, BROKEN ARROW, OK 74012-5996
(918) 608-1212
(918) 289-2606
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
944
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
944
LINCENSE
OK
Enumeration date
01/29/2021
Last updated
01/29/2021
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