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Individual

MRS. MORGAN NICOLE PEDEN JUDICE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA

Contact information

Practice address
604 FM 1293 RD, KOUNTZE, TX 77625-7804
(409) 658-0961
Mailing address
1390 KALAS CIR, LUMBERTON, TX 77657-1172
(409) 658-0961

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
214851

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
214851
TEXAS BOARD OF OCCUPATIONAL THERAPY EXAMINERS
TX
Enumeration date
10/31/2018
Last updated
10/31/2018
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