Individual
MATTHEW LEE MIMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
603 LEAFLET LN, SPRING, TX 77388-5961
(214) 422-3631
Mailing address
603 LEAFLET LN, SPRING, TX 77388-5961
(214) 422-3631
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
210118
TX
224Z00000X
Occupational Therapy Assistant
2974
NM
Other
Enumeration date
01/11/2013
Last updated
08/23/2023
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