Individual
XOA T VO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4157 S HARVARD AVE STE 117, TULSA, OK 74135-2606
(918) 712-7868
Mailing address
4157 S HARVARD AVE STE 117, TULSA, OK 74135-2606
(918) 712-7868
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
5745
OK
Other
Enumeration date
03/03/2023
Last updated
03/03/2023
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