Individual
MISS DALTON ADAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
402 EMMETT ST, BRYAN, TX 77802-1603
(936) 645-0580
Mailing address
402 EMMETT ST, BRYAN, TX 77802-1603
(936) 645-0580
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
210472
TX
Other
Enumeration date
05/10/2012
Last updated
05/10/2012
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