Individual
MRS. TAYLOR ANN WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
4257 RUFE SNOW DR APT 622, NORTH RICHLAND HILLS, TX 76180-8572
(817) 914-3148
Mailing address
4257 RUFE SNOW DR APT 622, NORTH RICHLAND HILLS, TX 76180-8572
(817) 914-3148
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
215778
TX
Other
Enumeration date
09/16/2019
Last updated
09/16/2019
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