Individual
CHIARA TEVYAN FIALLOS-MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
3576 W 4TH ST, FORT WORTH, TX 76107-2053
(817) 734-7682
Mailing address
3576 W 4TH ST, FORT WORTH, TX 76107-2053
(817) 734-7682
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
112161
TX
Other
Enumeration date
08/18/2011
Last updated
08/18/2011
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