Individual
JESSICA RICHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2305 LONGMIRE DR STE 300, COLLEGE STATION, TX 77845-7034
(972) 422-1860
Mailing address
15634 SHADY BROOK LN, COLLEGE STATION, TX 77845-1106
(413) 854-3200
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
120180
TX
Other
Enumeration date
08/23/2020
Last updated
06/29/2021
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