Individual
COURTNEY WATERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6301 GASTON AVE STE 750, DALLAS, TX 75214-3922
(214) 295-5374
Mailing address
1412 CHEYENNE DR, RICHARDSON, TX 75080-3921
(214) 212-5862
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
119655
TX
Other
Enumeration date
04/07/2019
Last updated
04/07/2019
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