Individual
MRS. TAMARA PATOCKA WALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
120 N PERKINS RD STE F, STILLWATER, OK 74075-5524
(405) 564-2701
Mailing address
4705 W 44TH ST, STILLWATER, OK 74074-2083
(405) 707-0779
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1043
OK
Other
Enumeration date
03/27/2007
Last updated
03/25/2020
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