Individual
MR. MO DASABE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
658 SW 3RD ST, GRAND PRAIRIE, TX 75051-1805
(972) 264-2464
Mailing address
4403 PALMER DR, MANSFIELD, TX 76063-3434
(972) 572-8900
Taxonomy
Speciality
Code
Description
License number
State
224ZE0001X
Environmental Modification Occupational Therapy Assistant
Primary
208620
TX
Other
Enumeration date
08/22/2018
Last updated
08/22/2018
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