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Individual

CHEROTICH PICOTY LEITICH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
7021 BRYANT IRVIN RD, FORT WORTH, TX 76132-4243
(817) 332-7003
Mailing address
7021 BRYANT IRVIN RD, FORT WORTH, TX 76132-4243

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
117281
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1770972572
SNF
05
1972742815
TX
Enumeration date
02/08/2019
Last updated
02/08/2019
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