Individual
JACQUELYN FAYE REAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
6525 N MERIDIAN AVE, SUITE 311, OKLAHOMA CITY, OK 73116-1420
(405) 721-1115
Mailing address
6105 NORWICH CT, OKLAHOMA CITY, OK 73132-2604
(405) 210-6049
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
338
OK
Other
Enumeration date
08/31/2012
Last updated
08/31/2012
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