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General NPI Number Information
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NPI Number | 1760875231
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Entity Type | Individual
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Provider Name | LORI WILLIAMS COTA/L
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Gender | Female
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Dates
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Enumeration Date | 03/09/2015
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Last Update Date | 02/14/2023
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Provider Practice Location Address
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Address Line | 120 N PERKINS RD STE F
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City | STILLWATER
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State | OK
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Zip | 74075-5524
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Country | US
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Telephone | 918-899-3190
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Fax |
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Provider Business Mailing Address
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Address Line | 120 N PERKINS RD
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City | STILLWATER
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State | OK
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Zip | 74075-5524
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Country | US
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Telephone | 918-899-3190
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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 | 213140
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License Number State | TX
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