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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Thursday, December 19, 2024 3:44 AM CST
Next Update: Thursday, December 19, 2024 12:00 PM CST

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LONG, SIDNEY RAIN       
This verification service provides current data extracted by the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) from its own database. The data enclosed in the green box below is provided by and controlled entirely by the OSBMLS and therefore constitutes a primary source verification of licensure status as authentic as a direct inquiry to the OSBMLS. NPI# and hospital privileges (if any) are provided by the licensee and not verified.
Practice Address: NOVO
1805 E 15TH ST
TULSA OK 74110

Address last updated on 10/22/2024
Phone #:
Fax #:
County: TULSA
License: 1850
Dated: 8/2/2017
Expires: 10/31/2025
License Type: Occupational Therapy Assistant
Specialty:
Status: Active
Status Class: Fully Licensed
Restricted to:
CME Year: 2026
Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Locations: Hours: Languages:
NOVO
1805 E 15TH ST
TULSA OK 74110

Phone #:
Fax #:
Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
KATHY SHANNON SHEPARD OT 5375

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