Individual
CHAD ROLDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
6402 COUNTRYSIDE DR, TEXARKANA, AR 71854
(903) 277-1228
Mailing address
6402 COUNTRYSIDE DR, TEXARKANA, AR 71854-2419
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
912237707
DRIVERS LICENSE
—
Enumeration date
05/10/2018
Last updated
06/16/2018
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