Organization
CHILDREN'S SPOT 4 THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JESSICA CLICKENER OTR (OCCUPATIONAL THERAPIST)
(254) 781-3447
Entity
Organization
Contact information
Practice address
2300 E RANCIER AVE STE 106, KILLEEN, TX 76543-3450
(254) 781-3447
(254) 227-6163
Mailing address
1121 WESTWAY DR, TEMPLE, TX 76502-5151
(361) 523-1049
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
204183201
—
TX
Enumeration date
08/02/2018
Last updated
08/02/2018
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