Organization
CIRCLE OF LIFE THERAPY, PLLC
Active
Other names
COLT
Organization subpart
No
Provider details
NPI number
Authorized official
LATARA HART MOT (OWNER)
(469) 580-9733
Entity
Organization
Contact information
Practice address
2993 S WATSON RD, 200, GRAND PRAIRIE, TX 75052
(469) 580-9733
(214) 988-1542
Mailing address
2993 S STATE HIGHWAY 360 STE 200, GRAND PRAIRIE, TX 75052-8906
(469) 580-9733
(214) 988-1542
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
405282201
—
TX
05
—
483216401
—
TX
Enumeration date
03/19/2019
Last updated
07/28/2024
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