Gayle Cline, OTR

Individual provider Active NPI Occupational Therapist · Wagoner, OK

NPI 1023345824 · NPPES record last updated Nov 16, 2009

Key facts

NPI
1023345824
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
OT817 (OK)
Practice address
31197 E 683 Dr
Wagoner, OK 74467-6396
Phone
(918) 462-0905
NPI assigned
Nov 16, 2009
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
954WYMDClinical Social Worker
OT817OKMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Holistic Pain Management of Wyoming, LLC Past Accepting new patients
William H and Carrie Gottsche Foundation Past
since Nov 1, 2005
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT817 OK Yes

Addresses

Primary practice location

31197 E 683 Dr
Wagoner, OK 74467-6396

Mailing address

31197 E 683 Dr
Wagoner, OK 74467-6396
Phone (918) 462-0905

Other providers in Wagoner, OK

All providers in Wagoner, OK · Occupational Therapist in Oklahoma

Sources for this page

Verify at the official NPI Registry.