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1578008322
LESLEY DIANE FAIN
TAHLEQUAH, OK
NPI
1578008322
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: OK 2065)
Enumeration Date
2017-01-04
Last Update Date
2017-01-04
Business Address
LESLEY DIANE FAIN OTR/L
100 S BLISS AVE
TAHLEQUAH, OK 74464-2512
Phone number: 918-458-3100
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Mailing Address
LESLEY DIANE FAIN OTR/L
16959 W 737 RD
TAHLEQUAH, OK 74464-1069
Phone number: 918-316-0538
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