Organization · NPI-2

40:31 Rehab & Wellness, PLLC.

Occupational Therapist · Muskogee, OK

NPI number1578081634
StatusActive
Last updated in NPPESSep 10, 2026

Details

NPI
1578081634
Entity type
Organization (NPI-2)
Legal business name
40:31 Rehab & Wellness, PLLC.
Organization subpart
No
Enumeration date
Sep 8, 2017
Certification date
Sep 10, 2026
Last updated
Sep 10, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225X00000X Occupational Therapist2138OKYes
224Z00000X Occupational Therapy Assistant––
225XM0800X Occupational Therapist, Mental Health––
2355S0801X Specialist/Technologist, Speech-Language Assistant––
235Z00000X Speech-Language Pathologist,––

Practice location

1805 N York St Ste H
Muskogee, OK 74403-1442

Phone 918-912-2796 · Fax 918-513-5808

Mailing address

1805 N York St Ste H
Muskogee, OK 74403-1442

Phone 918-912-2796 · Fax 918-513-5808

Authorized official

Tara Michelle Ottenbacher
Owner
5809828316

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