Haley Boydston, COTA/L

Individual provider Active NPI Occupational Therapy Assistant · Tahlequah, OK

NPI 1558026948 · NPPES record last updated Jan 24, 2025

Key facts

NPI
1558026948
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
2353 (OK)
Practice address
19600 E Ross St
Tahlequah, OK 74464-0545
Phone
(539) 234-1000
NPI assigned
Nov 1, 2021
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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)
No

State licenses

LicenseStateTypeSpecialty
2353OKMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Cherokee Nation Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 2353 OK Yes

Addresses

Primary practice location

19600 E Ross St
Tahlequah, OK 74464-0545

Mailing address

19600 E Ross St
Tahlequah, OK 74464-0545
Phone (539) 234-1000

Other providers in Tahlequah, OK

All providers in Tahlequah, OK · Occupational Therapy Assistant in Oklahoma

Sources for this page

Verify at the official NPI Registry.