Individual
HALEY LYNN RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
799 S LEE ST, FORT GIBSON, OK 74434-8708
(918) 616-8490
Mailing address
799 S LEE ST, FORT GIBSON, OK 74434-8708
(918) 616-8490
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2462
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200536910
—
OK
Enumeration date
01/20/2023
Last updated
06/22/2026
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