Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 943 | OK |
NPI | 1023399284 |
---|---|
Provider Name | Mrs. Carla Cathleen Lott |
First Address | Bixby, OK 74008-8266 |
Second Address | Broken Arrow, OK 74012-3628 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2011 |
Last Update Date | 18/05/2016 |