Individual
MRS. JUDITH EMERSON-ENNIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
901 PENNSYLVANIA AVE, FORT WORTH, TX 76104-2226
(817) 915-5860
Mailing address
5216 COVENTRY CT, COLLEYVILLE, TX 76034-5513
(817) 915-5860
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
110150
TX
Other
Enumeration date
12/04/2024
Last updated
12/04/2024
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