Individual
MANDY ELIZABETH MCCLISTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3434 WATTERS RD, PASADENA, TX 77504-2015
(281) 941-9155
Mailing address
1210 PINE MOSS CT, PEARLAND, TX 77581-8819
(281) 941-9155
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
208667
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
208667
LONG TERM CARE
TX
Enumeration date
08/28/2018
Last updated
08/28/2018
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