Individual
MRS. MARY ALICE CASILLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2500 E MAIN ST, ALICE, TX 78332-4169
(361) 661-8000
Mailing address
4238 ADRIANNA DR, CORPUS CHRISTI, TX 78413-4455
(361) 779-9572
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
209833
TX
Other
Enumeration date
05/21/2007
Last updated
07/08/2007
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