Individual
MS. MARVE SOUTHERLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4200 LIVE OAK ST, DALLAS, TX 75204-6733
(214) 515-6131
Mailing address
4200 LIVE OAK ST, DALLAS, TX 75204-6733
(214) 515-6131
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
212385
TX
Other
Enumeration date
01/21/2015
Last updated
01/21/2015
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