Individual
MRS. DEIDRE LYNN FERGASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
3505 OLD JACKSONVILLE HWY, TYLER, TX 75703
(903) 368-0357
Mailing address
3505 OLD JACKSONVILLE HWY, TYLER, TX 75703
(903) 368-0357
Taxonomy
Speciality
Code
Description
License number
State
224ZE0001X
Environmental Modification Occupational Therapy Assistant
Primary
103800
TX
Other
Enumeration date
09/05/2018
Last updated
09/05/2018
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