Individual
MRS. TYWONDA COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2409 HYDRANGEA AVE, KILLEEN, TX 76549-5092
(254) 319-3923
(254) 699-1547
Mailing address
2409 HYDRANGEA AVE, KILLEEN, TX 76549-5092
(254) 319-3923
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
210067
TX
Other
Enumeration date
08/23/2018
Last updated
08/23/2018
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