Individual
CHANNA NOWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
5455 KNICKERBOCKER RD, SAN ANGELO, TX 76904-7711
(325) 944-1600
Mailing address
1702 PARKER ST, SAN ANGELO, TX 76901-1838
(325) 451-9839
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
213347
TX
Other
Enumeration date
08/30/2018
Last updated
08/30/2018
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