Individual
MRS. STACEY ELAINE DAWES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
2025 S ASTER AVE, BROKEN ARROW, OK 74012-6075
(918) 606-8282
Mailing address
2025 S ASTER AVE, BROKEN ARROW, OK 74012-6075
(918) 606-8282
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2065
OK
Other
Enumeration date
01/13/2021
Last updated
01/13/2021
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