Organization
OK-THERAPLAY
Active
Organization
OK-THERAPLAY
Active
Other names
OK-Theraplay
Organization subpart
No
Provider details
NPI number
Authorized official
KORTNEI DIANE GUTIERREZ COTA (OWNER)
(580) 318-9415
Entity
Organization
Contact information
Practice address
1205 KINGSTON BLVD, EDMOND, OK 73034-3227
(580) 318-9415
(405) 999-4998
Mailing address
1205 KINGSTON BLVD, EDMOND, OK 73034-3227
(580) 318-9415
(405) 999-4998
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1609488238
—
OK
Enumeration date
04/28/2021
Last updated
04/28/2021
Update your record
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