Individual
EDITH MIDDLETON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1617 PARK PLACE AVE, #110, FORT WORTH, TX 76110-1300
(817) 921-5020
Mailing address
1404 BARRON LN, FORT WORTH, TX 76112-3449
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
107544
TX
Other
Enumeration date
06/30/2009
Last updated
06/30/2009
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