Individual
CHAMROEUN NICOLE LEISEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2310 ELDRIDGE PKWY, HOUSTON, TX 77077-5254
(281) 558-3900
Mailing address
2310 ELDRIDGE PKWY, HOUSTON, TX 77077-5254
(281) 658-1337
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
215390
TX
Other
Enumeration date
07/06/2022
Last updated
07/06/2022
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