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NPI Code Detail

MEDICARE: MRS. SAVANNAH LYNN SMITH COTA/L

MEDICARE: MRS. SAVANNAH LYNN SMITH COTA/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1224Z00000XOccupational Therapy Assistant1374OK

General Provider Information

NPI Number : 1679156228
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SAVANNAH LYNN SMITH COTA/L
Provider Business Mailing Address
First Line : 1815 E SKELLY DR
Second Line :
City : TULSA
State : OK
Zip : 74105-5919
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1815 E SKELLY DR
Second Line :
City : TULSA
State : OK
Zip : 74105-5919
Country : US
Telephone Number : 918-743-7838
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2021
Last Update Date : 05/02/2021

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Directions to “ MRS. SAVANNAH LYNN SMITH COTA/L” Practice Location

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