Lacy Lin Vadder, COTA/L
Occupational Therapy Assistant in Hennessey, OK. Individual provider (NPI-1).
NPI number1194166264
StatusActive
Last updated in NPPESJul 17, 2013
Details
- NPI
- 1194166264
- Entity type
- Individual (NPI-1)
- Name
- Lacy Lin Vadder
- Credential
- COTA/L
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 17, 2013
- Last updated
- Jul 17, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 224Z00000X | Occupational Therapy Assistant | 844 | OK | Yes |
Practice location
1679 N 2780 RdHennessey, OK 73742-6624
Phone 405-853-1210
Mailing address
1679 N 2780 RdHennessey, OK 73742-6624
Phone 405-853-1210
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