Individual
JESSICA HACKWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
101 POSEY AVE, CLIFTON, TX 76634-1289
(254) 675-7955
Mailing address
101 POSEY AVE, CLIFTON, TX 76634-1289
(254) 675-7955
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
209891
TX
Other
Enumeration date
08/06/2020
Last updated
08/06/2020
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