Individual
SIMONE WALLIS BOOTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
811 GARNER RD, PASADENA, TX 77502-2315
(786) 899-7346
Mailing address
811 GARNER RD, PASADENA, TX 77502-2315
(786) 899-7346
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
211624
TX
Other
Enumeration date
09/04/2018
Last updated
09/04/2018
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