Lake, Bonnie Sue

Lake, Bonnie Sue is an individual health care provider with primary practice located at 1425 S Santa Fe Ave Suite E, Edmond OK 73003-5901. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as her primary health care specialty. Lake, Bonnie Sue can be contacted via phone (405) 285-8845.

Contact Information

Primary practice address
1425 S Santa Fe Ave Suite E Edmond OK 73003-5901
Phone: (405) 285-8845
Fax: (405) 285-8848
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X 1070 Oklahoma

Profile Details

NPI number 1568780385
LBN Legal business name Lake, Bonnie Sue
Credentials Occupational Therapist (OT)
Entity Individual
Sole proprietor 1 No
Enumeration date May 5th, 2010
Last updated Aug 27th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568780385 NPPES
Oklahoma MEDICAID 200286380A

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