Individual
LORI DESHEA NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
5502 4TH ST, LUBBOCK, TX 79416-4220
(806) 544-8198
Mailing address
730 6TH PL, IDALOU, TX 79329-9055
(806) 544-8198
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
210861
TX
Other
Enumeration date
08/22/2018
Last updated
08/22/2018
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