Marlene S Snow, OTR/L, MS, SCLV, CDE
Individual provider Active NPI Low Vision Occupational Therapist · Newalla, OK
NPI 1154477057 · NPPES record last updated Feb 3, 2020
Key facts
- NPI
- 1154477057
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Low Vision Occupational Therapist 225XL0004X
- License
- 802 (OK)
- Practice address
- 18433 Sierra LN
Newalla, OK 74857-8449 - Phone
- (405) 391-2115
- NPI assigned
- Jan 25, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20091203000294 | OK | Practitioner - Occupational Therapist in Private Practice | 4284773300 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21801092 | OK | MD | Diabetes Educator Registered Nurse |
| OT802 | OK | MD | Contractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diabetes Educator Registered Nurse |
163WD0400X | 21801092 | OK | |
| Contractor | 171W00000X | OT802 | OK | |
| Occupational Therapist | 225X00000X | |||
| Environmental Modification Occupational Therapist | 225XE0001X | 802 | OK | |
| Low Vision Occupational Therapist |
225XL0004X | 802 | OK | Yes |
Addresses
Primary practice location
18433 Sierra LN
Newalla, OK 74857-8449
Mailing address
18433 Sierra LN
Newalla, OK 74857-8449
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 21801092 | Other | NATIONAL CERTIFICATION BOARD FOR DIABETES EDUCATORS | |
| 200051810B | Medicaid | OK |
Other providers in Newalla, OK
All providers in Newalla, OK · Low Vision Occupational Therapist in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 3, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.