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Individual

MRS. LINDSEY BLACKSHEAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA

Contact information

Practice address
451 S EL CAMINO XING, SAN AUGUSTINE, TX 75972-1666
(936) 275-2900
Mailing address
835 COUNTY ROAD 3754, CENTER, TX 75935-7326

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
211133
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
211133
TBOTE
TX
Enumeration date
08/23/2018
Last updated
08/23/2018
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