Individual
LACY LIN VADDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1679 N 2780 RD, HENNESSEY, OK 73742-6624
(405) 853-1210
Mailing address
1679 N 2780 RD, HENNESSEY, OK 73742-6624
(405) 853-1210
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
844
OK
Other
Enumeration date
07/17/2013
Last updated
07/17/2013
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