Individual
MS. KIMBERLY DAWN SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
811 E VIRGINIA AVE, STILLWATER, OK 74075-7919
(405) 377-8255
(405) 835-3920
Mailing address
15413 S CR 207, BLAIR, OK 73526-9256
(580) 301-4277
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
952
OK
Other
Enumeration date
12/05/2007
Last updated
05/02/2022
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