Individual
MS. TRISTA LASHAUN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
419 S COCKRELL HILL RD, DUNCANVILLE, TX 75116-4939
(972) 708-8801
Mailing address
1401 JUDY LN, MANSFIELD, TX 76063-8659
(318) 613-2674
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
210715
TX
Other
Enumeration date
07/15/2018
Last updated
07/15/2018
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