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Individual

MS. MARILYN JOYCE AVERY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.T.A.

Contact information

Practice address
4300 W HOUSTON ST, BROKEN ARROW, OK 74012-4519
(918) 254-5000
(918) 250-2538
Mailing address
1504 E 37TH ST, TULSA, OK 74105-3224
(918) 742-5991

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
586
OK

Other

Enumeration date
11/14/2007
Last updated
11/14/2007
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