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Individual

ROBIN WALLACE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA

Contact information

Practice address
15700 WYOMING DR, SUITE 221, FRISCO, TX 75035-6696
(908) 894-0532
Mailing address
15700 WYOMING DR, FRISCO, TX 75035-6696

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
212138
TX
224Z00000X
Occupational Therapy Assistant
OTA1369
CA

Other

Enumeration date
06/24/2011
Last updated
11/04/2015
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