Individual
AMY M HRISTOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
6636 S MINGO RD, TULSA, OK 74133-3247
(918) 357-6655
Mailing address
413 S BEECH AVE, BROKEN ARROW, OK 74012-3404
(918) 728-1596
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1878
OK
Other
Enumeration date
11/17/2020
Last updated
11/17/2020
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