Individual
JENNIE LEE TATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RT
Contact information
Practice address
2201 SE LOOP 820, FORT WORTH, TX 76119-5863
(817) 730-0327
Mailing address
2201 SE LOOP 820, FORT WORTH, TX 76119-5863
(817) 730-0327
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
—
—
Other
Enumeration date
05/27/2021
Last updated
05/27/2021
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