Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 2027 | OK |
NPI | 1013507649 |
---|---|
Provider Name | Ashlee Mitchell |
First Address | Oklahoma City, OK 73162-5326 |
Second Address | Midwest City, OK 73130-6347 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2021 |
Last Update Date | 18/01/2021 |