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Individual

HEATHER GARDNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
930 W CENTERVILLE RD, SUITE C, GARLAND, TX 75041-5823
(972) 303-7021
(817) 789-6849
Mailing address
305 NE LOOP 820, BUSINESS TOWER 1; SUITE 200, HURST, TX 76053-7209
(817) 292-8787
(817) 789-6849

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
403982
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
149984001
TX
05
207164901
TX
Enumeration date
03/13/2013
Last updated
03/13/2013
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