Provider Demographics
NPI:1194133249
Name:FARROW, KATIE
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:FARROW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:739 BREWER LOOP
Mailing Address - Street 2:
Mailing Address - City:KIOWA
Mailing Address - State:OK
Mailing Address - Zip Code:74553-5087
Mailing Address - Country:US
Mailing Address - Phone:918-424-4540
Mailing Address - Fax:
Practice Address - Street 1:402 W MAIN ST
Practice Address - Street 2:
Practice Address - City:ANTLERS
Practice Address - State:OK
Practice Address - Zip Code:74523-2087
Practice Address - Country:US
Practice Address - Phone:580-298-9818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-31
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1183224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant