Individual
CATHERINE GRACE JEZEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
2552 E KENOSHA ST, BROKEN ARROW, OK 74014-6712
(918) 893-3735
Mailing address
2012 E PRINCETON ST, BROKEN ARROW, OK 74012-2095
(405) 306-9507
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2399
OK
Other
Enumeration date
05/06/2022
Last updated
05/06/2022
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