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Individual

LAURA SHADE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
812 E WARD DR, ROBINSON, TX 76706-5924
(254) 214-3341
Mailing address
812 E WARD DR, ROBINSON, TX 76706-5924
(254) 214-3341

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
110937
TX

Other

Enumeration date
08/22/2018
Last updated
08/22/2018
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