Individual
STACY JEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
15035 FELGATE CREEK DR, HOUSTON, TX 77084-1470
(401) 660-8112
Mailing address
15035 FELGATE CREEK DR, HOUSTON, TX 77084-1470
(401) 660-8112
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
474043
TX
Other
Enumeration date
08/25/2022
Last updated
08/25/2022
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