Provider Demographics
NPI:1851280051
Name:JOSEPH, LYDIA M (OTR/L)
Entity type:Individual
Prefix:
First Name:LYDIA
Middle Name:M
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11208 NW 103RD ST
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-8275
Mailing Address - Country:US
Mailing Address - Phone:405-898-9626
Mailing Address - Fax:
Practice Address - Street 1:11208 NW 103RD ST
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-8275
Practice Address - Country:US
Practice Address - Phone:405-898-9626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-01
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5533225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist