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General NPI Number Information
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NPI Number | 1407445224
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Entity Type | Individual
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Provider Name | MAGALIT WOLFE COTA/L
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Gender | Female
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Dates
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Enumeration Date | 01/15/2021
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Last Update Date | 01/15/2021
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Provider Practice Location Address
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Address Line | 4908 S SHERIDAN RD
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City | TULSA
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State | OK
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Zip | 74145-5712
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Country | US
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Telephone | 918-984-9153
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Fax | 918-289-0579
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Provider Business Mailing Address
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Address Line | 14712 E 108TH ST N
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City | OWASSO
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State | OK
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Zip | 74055-6112
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Country | US
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Telephone | 316-210-1564
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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 | 1289
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License Number State | OK
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