Individual
MALLORY JO SPENCER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
4159 FM 13 W, HENDERSON, TX 75654-9395
(903) 646-3742
Mailing address
4159 FM 13 W, HENDERSON, TX 75654-9395
(903) 646-3742
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
215209
TX
Other
Enumeration date
05/08/2020
Last updated
05/08/2020
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