Individual
TAYLOR NICOLE MCINTOSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2257 W WASHINGTON ST, BROKEN ARROW, OK 74012-6703
(918) 994-7799
Mailing address
3857 SOUTHRIDGE CIR APT 4, TAHLEQUAH, OK 74464-7957
(580) 212-6012
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
5468
OK
Other
Enumeration date
09/22/2020
Last updated
11/05/2021
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