Individual
CARLEY MICHELLE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3401 AMADOR DR, FORT WORTH, TX 76177-2227
(682) 204-0853
Mailing address
12880 NS 3590, WEWOKA, OK 74884-5402
(405) 398-4761
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
NONE
—
225100000X
Physical Therapist
Primary
2162102
TX
Other
Enumeration date
04/23/2007
Last updated
07/14/2021
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