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Organization

MUSTARD SEEDS THERAPY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. CRYSTAL D TURNER OTR (OCCUPATIONAL THERAPIST)
(817) 541-7770
Entity
Organization

Contact information

Practice address
212 N. OAK STREET, ROANOKE, TX 76262
(817) 541-7770
Mailing address
212 N. OAK STREET, ROANOKE, TX 76262
(817) 541-7770

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
107888
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
107888
OCCUPATIONAL THERAPY LICENSE NUMBER
TX
Enumeration date
04/24/2014
Last updated
04/24/2014
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