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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Thursday, September 26, 2024 1:21 PM CDT
Next Update: Thursday, September 26, 2024 4:30 PM CDT

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MALCOLM, MADISON NICOLE       
Practice Address: ELITE PEDIATRIC THERAPY
4800 W SAN ANTONIO ST
STE 101
BROKEN ARROW OK 74012

Address last updated on 6/20/2024
Phone #: (918) 417-8740
Fax #:
County: TULSA
License: 2281
Dated: 2/9/2021
Expires: 10/31/2024
Temp. Ltr. Issued: 12/11/2020
Temp. Ltr. Expires: 3/11/2021
License Type: Occupational Therapy Assistant
Specialty:
Status: Active
Status Class: Fully Licensed
Restricted to:
CME Year: 2024
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:
ELITE PEDIATRIC THERAPY
4800 W SAN ANTONIO ST
STE 101
BROKEN ARROW OK 74012

Phone #: (918) 417-8740
Fax #:
Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
ALEXIS ERIN LANGSTON OT 2107

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