Individual
EDNA ITZEL ROBLEDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
3137 SPYGLASS DR, GRAND PRAIRIE, TX 75052-7508
(469) 422-5803
Mailing address
3137 SPYGLASS DR, GRAND PRAIRIE, TX 75052-7508
(469) 422-5803
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
216261
TX
Other
Enumeration date
01/13/2021
Last updated
01/13/2021
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