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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Wednesday, December 18, 2024 6:43 PM CST
Next Update: Thursday, December 19, 2024 2:50 AM CST

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OTTENBACHER, TARA MICHELLE       
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: 40.31 REHAB & WELLNESS PLLC.
1805 N YORK ST.
SUITE H
MUSKOGEE OK 74403

Address last updated on 11/22/2024
Phone #: (918) 912-2796
Fax #: (918) 513-5808
County: MUSKOGEE
License: 2138
Dated: 9/8/2017
Expires: 10/31/2025
License Type: Occupational Therapist
Specialty: Pediatrics (OT/OA only)
School Based Practice (OT/OA only)
Community Mental Health (OT/OA only)
Home and Community Health (OT/OA only)
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:
40.31 REHAB & WELLNESS PLLC.
1805 N YORK ST.
SUITE H
MUSKOGEE OK 74403

Phone #: (918) 912-2796
Fax #: (918) 513-5808
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
ALANA MARIE JORDAN OA 2084
AUSTYN STILLS OA 2465

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