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Individual

MRS. SHEENA NICOLE WELLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA

Contact information

Practice address
1318 MEMORIAL DR, BRYAN, TX 77802-5215
(979) 776-2872
(979) 776-1456
Mailing address
1140 HOBO LN, MADISONVILLE, TX 77864-4869
(832) 671-9955

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
210697
TX

Other

Enumeration date
08/15/2011
Last updated
08/15/2011
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