Individual
KAHLILA FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTD, OTR/L,CEAS
Contact information
Practice address
522 W 16TH ST, ADA, OK 74820-7610
(405) 761-7740
(580) 421-9491
Mailing address
PO BOX 2297, ADA, OK 74821-2297
(405) 761-7740
(580) 421-9491
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1433
OK
225XE1200X
Ergonomics Occupational Therapist
—
—
225XG0600X
Gerontology Occupational Therapist
—
—
Other
Enumeration date
11/08/2008
Last updated
02/07/2011
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