Most Relevant Information
Provider Data
| NPI Number: | 1003583931 |
| Provider Name: | NANCY SKYLEEN BURK COTA/L |
| Entity Type: | Individual |
| Taxonomy Code: | 224Z00000X |
| Specialty: | Occupational Therapy Assistant |
| License Number: | 2356 |
Most Important Dates
| Enumeration Date: | 08/27/2021 |
| Last Updated: | 10/26/2022 |
Provider Practice Location
1510 N GRAND AVE
TAHLEQUAH
OK
744646318
Practice Location Phone/Fax
| Phone: | 9187082119 |
| Fax: |
Provider Mailing Location
PO BOX 384
BRAGGS
OK
744230384
Provider Mailing Phone/Fax
| Phone: | 9189100166 |
| Fax: |