Provider Demographics
NPI:1053974162
Name:STEPHENS, CASEY N (MOTR/L)
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:N
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:
Other - First Name:CASEY
Other - Middle Name:N
Other - Last Name:GRIFFIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MOTR/L
Mailing Address - Street 1:12400 S HIWASSEE RD
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73165-7681
Mailing Address - Country:US
Mailing Address - Phone:405-833-1013
Mailing Address - Fax:
Practice Address - Street 1:12400 S HIWASSEE RD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73165-7681
Practice Address - Country:US
Practice Address - Phone:405-833-1013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-16
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1509224Z00000X
OK5528225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant