Individual
LESLIE JEFFERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED., OTR/L
Contact information
Practice address
504 WAR EAGLE LN, YUKON, OK 73099-5781
(405) 834-4819
Mailing address
504 WAR EAGLE LN, YUKON, OK 73099-5781
(405) 834-4819
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
643
OK
225XP0200X
Pediatric Occupational Therapist
Primary
643
OK
Other
Enumeration date
06/03/2014
Last updated
06/03/2014
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