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Individual

EMILY AYALA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1605 S EUCALYPTUS AVE STE 200, BROKEN ARROW, OK 74012-5996
(918) 608-1212
(918) 289-2606
Mailing address
1605 S EUCALYPTUS AVE STE 200, BROKEN ARROW, OK 74012-5996
(918) 608-1212
(918) 289-2606

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
225X00000X
Occupational Therapist
Primary
5703
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1886
LICSENSE
OK
01
5706
LICSENSE
OK
Enumeration date
01/15/2021
Last updated
11/08/2022
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