Individual
ANGELA CAVENDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
721 DUNAWAY LN, AZLE, TX 76020-2605
(321) 626-9610
Mailing address
2105 REMINGTON ST APT 15C, FORT WORTH, TX 76116-2163
(321) 626-9610
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
213032
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
213032
COTA
TX
Enumeration date
08/30/2018
Last updated
08/30/2018
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