Individual
ANGELINA MARIE VELASQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2601 ANDREA LN, SALLISAW, OK 74955-1890
(918) 774-8603
Mailing address
2601 ANDREA LN, SALLISAW, OK 74955-1890
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
L0057530
OK
224Z00000X
Occupational Therapy Assistant
Primary
1891
OK
Other
Enumeration date
10/16/2017
Last updated
10/16/2017
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