Individual
KYLIE LARGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
811 E VIRGINIA AVE, STILLWATER, OK 74075-7919
(405) 377-8255
Mailing address
811 E VIRGINIA AVE, STILLWATER, OK 74075-7919
(405) 377-8255
Taxonomy
Speciality
Code
Description
License number
State
224ZF0002X
Feeding, Eating & Swallowing Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
01/27/2022
Last updated
01/27/2022
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