Provider Demographics
NPI:1063090603
Name:GUESTHOUSE THERAPEUTICS LLC
Entity type:Organization
Organization Name:GUESTHOUSE THERAPEUTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:HANNAH
Authorized Official - Middle Name:
Authorized Official - Last Name:TYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-505-9485
Mailing Address - Street 1:2641 NW 34TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-7633
Mailing Address - Country:US
Mailing Address - Phone:951-505-9485
Mailing Address - Fax:
Practice Address - Street 1:701 W SHERIDAN AVE STE 301
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73102-2402
Practice Address - Country:US
Practice Address - Phone:951-505-9485
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-01
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty