Individual
JACQUELINE LOYOLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
100 E FERGUSON ST, TYLER, TX 75702
(903) 509-2040
Mailing address
1028 KICKAPOO ST, JACKSONVILLE, TX 75766-4630
(903) 283-5800
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
214112
TX
Other
Enumeration date
09/23/2016
Last updated
09/23/2016
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