Individual
TORI FANGUY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
158 COUNTY ROAD 1212, GARY, TX 75643-4357
(903) 754-7813
Mailing address
2999 FM 2667, TIMPSON, TX 75975-3179
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
215375
TX
Other
Enumeration date
10/22/2018
Last updated
10/22/2018
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