Individual
TANYA LOREE PETREE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
5813 E 143RD PL S, BIXBY, OK 74008-4138
(405) 706-7355
Mailing address
5813 E 143RD PL S, BIXBY, OK 74008-4138
(405) 706-7355
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
515
OK
Other
Enumeration date
05/05/2015
Last updated
02/03/2025
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