Individual
MARY KAY ISAACSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5930 E 31ST ST, SUITE 100, TULSA, OK 74135-5114
(918) 665-6160
Mailing address
3503 TIMBERLANE RIDGE DR, SAND SPRINGS, OK 74063-8461
(918) 246-0080
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT 412
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007428860B
—
OK
Enumeration date
10/05/2006
Last updated
07/09/2007
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