Raven Allen, COTA/L

Individual provider Active NPI Occupational Therapy Assistant · McAlester, OK

NPI 1831781269 · NPPES record last updated Feb 8, 2021

Key facts

NPI
1831781269
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
2073 (OK)
Practice address
101 Oklahoma Ave
McAlester, OK 74501-7520
Phone
(918) 421-3935
NPI assigned
Feb 8, 2021
Sex
Female
Sole proprietor
Yes

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
2073OKMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 2073 OK Yes

Addresses

Primary practice location

101 Oklahoma Ave
McAlester, OK 74501-7520

Mailing address

101 Oklahoma Ave
McAlester, OK 74501-7520
Phone (918) 421-3935

Other providers in McAlester, OK

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

Sources for this page

Verify at the official NPI Registry.