Individual
BIANCA CRYSTAL RETANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1411 DENVER AVE, DALHART, TX 79022-4809
(806) 244-0016
Mailing address
1106 BOB WHITE AVE, DUMAS, TX 79029-5382
(806) 930-8154
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
215324
TX
Other
Enumeration date
08/02/2018
Last updated
08/02/2018
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