Individual
KATRINA ANNETTE GILLHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOTR/L
Contact information
Practice address
104 N MAIN STREET, THOMAS, OK 73668
(405) 397-5957
Mailing address
3447 NW 18TH ST, NEWCASTLE, OK 73065-5988
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
1829
OK
Other
Enumeration date
02/19/2018
Last updated
02/19/2018
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