Provider Demographics
NPI:1952836710
Name:REED, ANDREA (COTA/L)
Entity Type:Individual
Prefix:MISS
First Name:ANDREA
Middle Name:
Last Name:REED
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 1:1536 CRESTVIEW CT
Mailing Address - Street 2:
Mailing Address - City:CUSHING
Mailing Address - State:OK
Mailing Address - Zip Code:74023-4730
Mailing Address - Country:US
Mailing Address - Phone:918-207-2724
Mailing Address - Fax:
Practice Address - Street 1:5800 E SKELLY DR
Practice Address - Street 2:SUITE 402
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-6471
Practice Address - Country:US
Practice Address - Phone:918-984-4408
Practice Address - Fax:888-317-1069
Is Sole Proprietor?:No
Enumeration Date:2017-04-28
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1298224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant