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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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PETTIJOHN, SHAMBRA LEANN
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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.
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| Practice Address: |
MINCO SCHOOLS AND AMBER POCASSET SCHOOLS
MINCO OK 73059
Address last updated on 10/27/2024 |
| Phone #: |
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| Fax #: |
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| County: |
GRADY |
| License: |
992 |
| Dated: |
11/1/2007 |
| Expires: |
10/31/2025 |
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Temp.
Ltr.
Issued:
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10/18/2007 |
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Temp.
Ltr.
Expires:
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11/3/2007 |
| License Type: |
Occupational Therapy Assistant |
| Specialty: |
School Based Practice (OT/OA only)
Sensory Integration (OT/OA only)
Attention Deficit Hyperactivity Disorder (OT/OA on
Handwriting (OT/OA only) |
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| Status: |
Active |
| Status Class: |
Fully Licensed |
| Restricted to: |
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| CME Year: |
2026 |
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Pending and/or Past Disciplinary Actions:
No Disciplinary Action Taken.
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All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
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Primary Supervisor(s):
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| Name: |
Type: |
License Number: |
Full/Part Time: |
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JULIE BETH MOORE
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OT |
947 |
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