Individual
LIANA MARIE CLEVENGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
9114 ROYAL LN, WACO, TX 76712-8469
(254) 666-2164
Mailing address
9114 ROYAL LN, WACO, TX 76712-8469
(254) 666-2164
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
208998
TX
Other
Enumeration date
11/29/2018
Last updated
11/29/2018
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