Individual
DAWN DENISE EZELLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
3400 MARINE DRIVE, FORT WORTH, TX 76135
(817) 237-7231
Mailing address
1200 DALLAS DR, 1314, DENTON, TX 76205-5151
(940) 206-6222
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
209409
TX
Other
Enumeration date
04/24/2007
Last updated
07/08/2007
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