Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 1433 | OK |
N | 2251E1200X | Ergonomics | ||
N | 225XE1200X | Ergonomics | ||
N | 225XG0600X | Occupational Therapist - Gerontology |
NPI | 1972757656 |
---|---|
Provider Name | Kahlila Fowler |
First Address | Ada, OK 74821-2297 |
Second Address | Ada, OK 74820-7610 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2008 |
Last Update Date | 07/02/2011 |