Individual
TARA LYNN MIDGLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1301 E ALBANY ST, BROKEN ARROW, OK 74012-8995
(918) 259-4500
Mailing address
701 S MAIN ST, BROKEN ARROW, OK 74012-5528
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2452
OK
Other
Enumeration date
07/26/2022
Last updated
07/26/2022
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