Individual
LAURA ELLAN FORDYCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
2351 W NORTHWEST HWY, SUITE 3270, DALLAS, TX 75220-4433
(972) 661-0883
Mailing address
2351 W NORTHWEST HWY, SUITE 3270, DALLAS, TX 75220-4433
(972) 661-0883
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
1073
OK
224Z00000X
Occupational Therapy Assistant
Primary
210773
TX
Other
Enumeration date
10/11/2011
Last updated
10/11/2011
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