Individual
MS. DONNA WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2300 POOL RD, GRAPEVINE, TX 76051-4254
(877) 852-6376
Mailing address
5200 TOWN AND COUNTRY BLVD APT 1410, FRISCO, TX 75034-6897
(806) 678-8207
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
208327
TX
Other
Enumeration date
08/12/2011
Last updated
08/12/2011
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