Individual
MRS. JENNIFER ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
5417 ALTAMESA BLVD, FORT WORTH, TX 76123-2804
(817) 292-8886
Mailing address
2209 KAITLYN DR, WEATHERFORD, TX 76087-4243
(817) 901-7197
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
211994
TX
Other
Enumeration date
01/29/2016
Last updated
01/29/2016
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