Individual
REGINA GUAJARDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
606 COYOTE TRL, ALICE, TX 78332-4004
(361) 664-5479
Mailing address
606 COYOTE TRL, ALICE, TX 78332-4004
(361) 446-0543
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
210507
TX
Other
Enumeration date
09/27/2018
Last updated
09/27/2018
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