Individual
MALINDA WANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
753 NW FORT SILL BLVD, LAWTON, OK 73507-5498
(580) 357-6900
Mailing address
753 NW FORT SILL BLVD, LAWTON, OK 73507-5498
(580) 357-6900
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
806
OK
Other
Enumeration date
04/16/2021
Last updated
04/16/2021
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