Individual
MRS. BERNARDINE KAY BAXTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
24845 S 610 RD, GROVE, OK 74344-0190
(419) 670-2201
Mailing address
24845 S 610 RD, GROVE, OK 74344-0190
(419) 670-2201
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA1200
OK
Other
Enumeration date
02/11/2014
Last updated
02/11/2014
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