Individual
BRENDA DESIRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13252 HARVEST RIDGE RD, FORT WORTH, TX 76244-8125
(754) 264-3015
Mailing address
13252 HARVEST RIDGE RD, FORT WORTH, TX 76244-8125
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
210687
TX
Other
Enumeration date
01/22/2015
Last updated
01/22/2015
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