Individual
JESSICA MARIE METCALF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
721 DUNAWAY LN # NA, AZLE, TX 76020-2605
(817) 444-2536
Mailing address
721 DUNAWAY LN, AZLE, TX 76020-2605
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
212615
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
212615
COTA LICENSE
TX
Enumeration date
01/23/2019
Last updated
01/23/2019
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