Individual
LESLI DIANE PAYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
220 VILLAGE CIR, PONCA CITY, OK 74601-4021
(580) 762-0121
(580) 576-7553
Mailing address
220 VILLAGE CIR, PONCA CITY, OK 74601-4021
(580) 762-0121
(580) 576-7553
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2286
OK
Other
Enumeration date
02/12/2021
Last updated
02/16/2021
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