Individual
DEDRIA BRYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
476 MARCELENE DR, WASKOM, TX 75692-6814
(903) 926-4342
Mailing address
476 MARCELENE DR, WASKOM, TX 75692-6814
(903) 926-4342
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
104205
TX
225X00000X
Occupational Therapist
105205
TX
Other
Enumeration date
11/20/2007
Last updated
08/15/2019
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