Individual
MS. BONNIE L LOCKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.O.T.A.
Contact information
Practice address
2501 MAPLE AVE, WACO, TX 76707-1337
(866) 724-8555
Mailing address
48315 WALDEN, MACOMB, MI 48044
(586) 909-3660
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
210140
TX
Other
Enumeration date
03/24/2008
Last updated
03/24/2008
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