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General NPI Number Information
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NPI Number | 1346829264
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Entity Type | Individual
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Provider Name | DEANNA FAY VANN-VEST COTA/L
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Gender | Female
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Dates
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Enumeration Date | 04/07/2021
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Last Update Date | 04/07/2021
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Provider Practice Location Address
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Address Line | 300 RANGER BLVD
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City | ROLAND
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State | OK
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Zip | 74954-4040
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Country | US
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Telephone | 918-427-5993
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Fax |
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Provider Business Mailing Address
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Address Line | 110379 S 4750 RD
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City | MULDROW
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State | OK
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Zip | 74948-5980
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Country | US
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Telephone | 479-652-4577
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 2293
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License Number State | OK
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