Individual
MRS. SANDRA MELISSA HAIRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
7716 WHITE PLAINS, AMARILLO, TX 79121
(806) 358-6164
Mailing address
7716 WHITE PLAINS, AMARILLO, TX 79121
(806) 358-6164
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
2049197
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2049197
LICENSE FOR PT
TX
Enumeration date
05/12/2008
Last updated
05/12/2008
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