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General NPI Number Information
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NPI Number | 1952218455
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Entity Type | Individual
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Provider Name | SHELBY L CHRISTIE L CHRISTIE COTA
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Gender | Female
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Dates
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Enumeration Date | 08/27/2026
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Last Update Date | 08/27/2026
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Provider Practice Location Address
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Address Line | 210 E CREEK AVE
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City | SALLISAW
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State | OK
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Zip | 74955-4608
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Country | US
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Telephone | 918-208-3775
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Fax |
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Provider Business Mailing Address
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Address Line | 102727 S 4614 RD
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City | SALLISAW
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State | OK
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Zip | 74955-5690
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Country | US
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Telephone | 479-414-4302
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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 | 2174
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License Number State | OK
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