Individual
ABBY GRACE MODISETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
3802 FM 450 N, HALLSVILLE, TX 75650-4240
(903) 738-7232
Mailing address
3802 FM 450 N, HALLSVILLE, TX 75650-4240
(903) 738-7232
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
217427
TX
Other
Enumeration date
06/21/2022
Last updated
06/21/2022
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