Individual
OLIVIA LYNN BLACKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
5110 S YALE AVE STE 102, TULSA, OK 74135-7438
(918) 492-2386
(918) 645-8686
Mailing address
6812 W 480, PRYOR, OK 74361-7592
(918) 693-1421
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2348
OK
Other
Enumeration date
07/07/2023
Last updated
07/07/2023
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