Individual
MS. OQUISHA LASHAY JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
900 W FORDALL ST APT 19, HENDERSON, TX 75652-6417
(903) 445-1654
Mailing address
900 W FORDALL ST APT 19, HENDERSON, TX 75652-6417
(903) 445-1654
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
211088
TX
Other
Enumeration date
01/05/2012
Last updated
01/05/2012
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