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Individual

TYANN SCACE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OT

Contact information

Practice address
991 W WILL ROGERS BLVD, CLAREMORE, OK 74017-5416
(918) 923-4700
(918) 923-4701
Mailing address
8245 E 330 RD, TALALA, OK 74080-9631

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1611
OK

Other

Enumeration date
10/04/2013
Last updated
10/04/2013
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