BRISTO, TRAGENE ADDIS - Licensee Information

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Last Update: Wednesday, May 1, 2024 1:43 PM CDT
Next Update: Wednesday, May 1, 2024 4:30 PM CDT

BRISTO, TRAGENE ADDIS

Practice Address:	INTERIM HOME HEALTH 3613 NW 56TH ST UNIT 385 OKLAHOMA CITY OK 73112 Address last updated on 10/4/2023
Phone #:	(405) 848-3555
Fax #:
County:	OKLAHOMA
License:	1815
Dated:	4/22/2013
Expires:	10/31/2024
License Type:	Occupational Therapist
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:
INTERIM HOME HEALTH 3613 NW 56TH ST UNIT 385 OKLAHOMA CITY OK 73112 Phone #: (405) 848-3555 Fax #:

Name:	Type:	License Number:	Full/Part Time:
Primary Supervisees(s):
SHANNON MUSIAL GOGEL	OA	1404

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Oklahoma State Board of Medical Licensure and Supervision :: 101 NE 51st St, Oklahoma City, OK 73105-1821
Main Number: (405) 962-1400 :: Fax: (405) 962-1440 :: Complaints outside 405 area code: 1-800-381-4519
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