Individual
OCTAVIA WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1901 N HWY 360 # 320, GRAND PRAIRIE, TX 75050-1412
(972) 239-3633
Mailing address
2929 DEANNE CT, FORT WORTH, TX 76123-2033
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
212413
TX
Other
Enumeration date
07/30/2018
Last updated
07/30/2018
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