Organization
EMPOWERING LIFE THERAPY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SAMANTHA PRATER OTR/L (OWNER/DIRECTOR)
(405) 694-7703
Entity
Organization
Contact information
Practice address
783 COUNTY STREET 2981, TUTTLE, OK 73089-1109
(405) 694-7703
(866) 721-5328
Mailing address
783 COUNTY STREET 2981, TUTTLE, OK 73089-1109
(405) 694-7703
(866) 721-5328
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
1721
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200341030B
—
OK
Enumeration date
08/07/2012
Last updated
08/07/2012
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