Individual
MICHELLE CAMPODONICO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
4113 GATEWAY DR, COLLEYVILLE, TX 76034-5609
(817) 793-7764
Mailing address
2903 ROXBORO RD, EULESS, TX 76039-4034
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
387385
TX
Other
Enumeration date
01/13/2018
Last updated
01/13/2018
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