Individual provider · Type 1 NPI

Raymond M. Wallace, COTA/L

Occupational Therapy Assistant · Broken Arrow, OK

NPI number 1003490228 Active

Practice location

6956 S 310th East Ave
Broken Arrow, OK 74014-5491

Call (918) 230-8099 Map

Specialties and licenses

TaxonomyCodeLicense
Occupational Therapy Assistant Primary 224Z00000X569 (OK)

Occupational Therapy Assistant: An occupational therapy assistant is a person who has graduated from an occupational therapy assistant program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, has successfully completed a period of supervised fieldwork experience required by the accredited occupational therapy assistant program, has passed a nationally recognized entry-level examinatio…

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About NPI 1003490228

Raymond M. Wallace, COTA/L's National Provider Identifier is 1003490228, issued on May 12, 2021. The primary taxonomy on file is Occupational Therapy Assistant (224Z00000X), and the practice location is in Broken Arrow, OK. The record was last updated on May 12, 2021.