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Individual

SHANTEL LAREA MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
2300 N BROADWAY ST, POTEAU, OK 74953-2009
(918) 962-0198
(844) 632-7298
Mailing address
204 LACEY LN UNIT D, POTEAU, OK 74953-5535
(918) 974-5650

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2141
OK

Other

Enumeration date
11/17/2021
Last updated
11/17/2021
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