Individual
MRS. JAIMIE LEIGH WARDLAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTA/L
Contact information
Practice address
7617 NW 133RD PL, OKLAHOMA CITY, OK 73142-4451
(405) 206-1242
Mailing address
521 N 2ND ST, OKEENE, OK 73763-9369
(580) 822-1585
Taxonomy
Speciality
Code
Description
License number
State
224ZE0001X
Environmental Modification Occupational Therapy Assistant
Primary
1233
OK
Other
Enumeration date
08/14/2013
Last updated
07/01/2015
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