Provider Demographics
NPI:1194742056
Name:SEN, ANITA (OT)
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:
Last Name:SEN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 W WILL ROGERS BLVD
Mailing Address - Street 2:
Mailing Address - City:CLAREMORE
Mailing Address - State:OK
Mailing Address - Zip Code:74017
Mailing Address - Country:US
Mailing Address - Phone:918-342-3800
Mailing Address - Fax:918-342-3900
Practice Address - Street 1:1810 N SIOUX ST
Practice Address - Street 2:STE C
Practice Address - City:CLAREMORE
Practice Address - State:OK
Practice Address - Zip Code:74017
Practice Address - Country:US
Practice Address - Phone:918-342-3800
Practice Address - Fax:918-342-3900
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1245225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200083510AMedicaid