MARIOTT, TY RANDALL - Licensee Information

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Last Update: Thursday, May 2, 2024 5:08 PM CDT
Next Update: Friday, May 3, 2024 2:50 AM CDT

MARIOTT, TY RANDALL

Practice Address:	SE PEDIATRIC THERAPY 1 CLARK BASS AVE MCALESTER OK 74501 Address last updated on 12/11/2023
Phone #:	(918) 421-3935
Fax #:
County:	PITTSBURG
License:	2523
Dated:	4/25/2023
Expires:	10/31/2024
License Type:	Occupational Therapy Assistant
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:
SE PEDIATRIC THERAPY 1 CLARK BASS AVE MCALESTER OK 74501 Phone #: (918) 421-3935 Fax #:

Name:	Type:	License Number:	Full/Part Time:
Primary Supervisor(s):
DEONA MARIE MONROE	OT	2134

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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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