Individual
KELLY RAE HALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
4300 W HOUSTON ST, BROKEN ARROW, OK 74012-4519
(919) 307-0233
Mailing address
4300 W HOUSTON ST, BROKEN ARROW, OK 74012-4519
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0977
OK
Other
Enumeration date
12/18/2012
Last updated
12/18/2012
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