Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
RAYMOND M WALLACE, COTA/L
Active Sole ProprietorRAYMOND M WALLACE, COTA/L is a Occupational Therapy Assistant healthcare provider located in BROKEN ARROW, Oklahoma. NPI 1003490228 is currently active in the NPPES registry. Verify at CMS.
Occupational Therapy Assistant · BROKEN ARROW, OK
Registration Details
- NPI Number
- 1003490228
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 12, 2021 (5.2985893558874 yrs)
- Last Updated
- May 12, 2021
- License
-
569 (OK)
- Sole Proprietor
- Yes
Practice Information
- Address
-
6956 S 310TH EAST AVEBROKEN ARROW, OK, 740145491Browse OK providers · Browse ZIP 74014
- Phone
- 9182308099
- Primary Specialty
-
Occupational Therapy Assistant
224Z00000X
Other Occupational Therapy Assistant Providers in BROKEN ARROW, OK
| Name | Credential | NPI |
|---|---|---|
| MR. VADIM NARUDSKY | COTA | 1407077951 |
| MS. MARILYN JOYCE AVERY | O.T.A. | 1033390448 |
| DALE LYNN NUAMAN | OTA | 1821265794 |
| AMY D GAUGER | — | 1780817619 |
| LISA JANELL SMITH | COTA | 1790918902 |
| KELLY RAE HALE | COTA/L | 1982940052 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.