Individual
BONNIE MEDLICOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2934 E 84TH ST, TULSA, OK 74137-1406
(918) 850-4697
Mailing address
2934 E 84TH ST, TULSA, OK 74137-1406
(918) 850-4697
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1388
OK
Other
Enumeration date
04/13/2022
Last updated
04/13/2022
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