Individual
JAISA D BERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1029 E WASHINGTON AVE, MCALESTER, OK 74501-4849
(918) 423-2220
Mailing address
10292 S BENTLEY RD, ATOKA, OK 74525-7491
(580) 364-3639
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2229
OK
Other
Enumeration date
09/02/2020
Last updated
03/23/2021
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