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Individual

LYNNETTE SALAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA

Contact information

Practice address
925 SANTA FE DR STE 110, WEATHERFORD, TX 76086-5867
(817) 599-7714
(254) 965-3618
Mailing address
515 W LINGLEVILLE RD, STEPHENVILLE, TX 76401-2211
(254) 965-3611
(254) 965-3618

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
212594
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
172242301
TX
Enumeration date
08/08/2018
Last updated
08/08/2018
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