Individual
EDALINE HINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
4500 S LANCASTER RD, DALLAS, TX 75216-7167
(469) 810-8593
Mailing address
701 LEGACY DR APT 1224, PLANO, TX 75023-2236
(469) 810-8593
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
215065
TX
Other
Enumeration date
11/21/2018
Last updated
11/21/2018
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