Chelsea K.Dawn Wood, COTA

Individual provider Active NPI Occupational Therapy Assistant · Lawton, OK

NPI 1366712416 · NPPES record last updated Jan 6, 2012

Key facts

NPI
1366712416
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
1009 (OK)
Practice address
4121 W Gore Blvd
Lawton, OK 73505-6336
Phone
(580) 353-8900
NPI assigned
Jan 6, 2012
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1009OKMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Gore Therapy Center, P.C. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 1009 OK Yes

Addresses

Primary practice location

4121 W Gore Blvd
Lawton, OK 73505-6336

Mailing address

4121 W Gore Blvd
Lawton, OK 73505-6336
Phone (580) 353-8900

Other providers in Lawton, OK

All providers in Lawton, OK · Occupational Therapy Assistant in Oklahoma

Sources for this page

Verify at the official NPI Registry.