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LACY CHEYENNE RICHARDSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA

Contact information

Practice address
6301 GASTON AVE, DALLAS, TX 75214-3922
(214) 295-5374
(214) 245-5217
Mailing address
6301 GASTON AVE, DALLAS, TX 75214-3922
(214) 295-5374
(214) 245-5217

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
214880
TX

Other

Enumeration date
01/23/2018
Last updated
01/23/2018
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