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Individual

MRS. SHONDA SHAREE HENLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA

Contact information

Practice address
4062 SUMMERHILL SQ, TEXARKANA, TX 75503-2730
(318) 401-4713
Mailing address
11150 KEATCHIE MARSHALL RD, KEATCHIE, LA 71046-9301
(318) 401-4713

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
212219
TX

Other

Enumeration date
02/26/2018
Last updated
02/26/2018
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