Individual
TESSA SHIRLENE WARREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
31133 STATE HIGHWAY 34B, WILLOW, OK 73673-8119
(580) 471-9982
Mailing address
507 W 6TH ST, GRANITE, OK 73547-9285
(580) 535-2104
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2159
OK
Other
Enumeration date
11/11/2021
Last updated
11/11/2021
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