Provider Demographics
NPI:1275208605
Name:BRUTON, KARA L (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:KARA
Middle Name:L
Last Name:BRUTON
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2225 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:OK
Mailing Address - Zip Code:74354-1620
Mailing Address - Country:US
Mailing Address - Phone:918-548-4101
Mailing Address - Fax:918-542-4410
Practice Address - Street 1:2225 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:OK
Practice Address - Zip Code:74354-1620
Practice Address - Country:US
Practice Address - Phone:918-548-4101
Practice Address - Fax:918-542-4410
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-09
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1670224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty