Individual
SHANNON CAUDILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3001 WEXFORD AVE, OKLAHOMA CITY, OK 73179-1248
(405) 664-5290
Mailing address
3001 WEXFORD AVE, OKLAHOMA CITY, OK 73179-1248
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1189
OK
Other
Enumeration date
04/06/2022
Last updated
04/06/2022
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