Individual
MRS. CONSTANCE SUE GRANT I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
7501 WALLACE BLVD, AMARILLO, TX 79124-2150
(806) 467-7000
Mailing address
4714 S AUSTIN ST, AMARILLO, TX 79110-2405
(806) 570-0529
(806) 367-7907
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
207514
TX
373H00000X
Day Training/Habilitation Specialist
207514
TX
Other
Enumeration date
04/08/2015
Last updated
02/13/2020
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