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Individual

KEALEY JORDAN OLIVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
3223 E. 31ST STEET, TULSA, OK 74105
(918) 250-7093
(918) 250-9976
Mailing address
3223 E. 31ST STEET, TULSA, OK 74105
(918) 250-7093
(918) 250-9976

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
2018024369
MO
225X00000X
Occupational Therapist
5225
OK
225XP0200X
Pediatric Occupational Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200910860A
OK
Enumeration date
11/13/2018
Last updated
11/27/2023
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