Individual
ALYSHA KIECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
14002 E 21ST ST STE 650, TULSA, OK 74134-1432
(918) 274-7902
Mailing address
9900 S 4103 RD, OOLOGAH, OK 74053-6270
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2550
OK
Other
Enumeration date
06/19/2023
Last updated
12/12/2023
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