Individual
JACOB PHILEMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
480 BRAY CENTRAL DR, ALLEN, TX 75013-6418
(972) 330-4397
Mailing address
480 BRAY CENTRAL DR, ALLEN, TX 75013-6418
(972) 330-4397
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
205364
TX
Other
Enumeration date
08/15/2017
Last updated
08/15/2017
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