Individual
LYDIA CANTRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
4617 BAKER ROAD, VALLIANT, OK 74764
(580) 212-5627
Mailing address
PO BOX 346, VALLIANT, OK 74764-0346
(580) 212-5627
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5381
OK
Other
Enumeration date
03/23/2022
Last updated
03/23/2022
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