Individual
HEIDI JANE KIDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
401 S COLTRANE RD STE 260, EDMOND, OK 73034-6722
(405) 921-6358
Mailing address
1002 SW 89TH ST APT 1008, OKLAHOMA CITY, OK 73139-9454
(405) 921-6358
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2512
OK
Other
Enumeration date
08/05/2024
Last updated
08/05/2024
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