Individual
JACQUELINE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT-A
Contact information
Practice address
6101 N STATE LINE AVE, TEXARKANA, TX 75503-5309
(903) 791-2270
(903) 792-0816
Mailing address
6101 N STATE LINE AVE, TEXARKANA, TX 75503-5309
(903) 791-2270
(903) 792-0816
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
211032
TX
224Z00000X
Occupational Therapy Assistant
Primary
OT-A644
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
211032
TEXAS BOARD OF OCCUPATIONAL THERAPY EXAMINERS
TX
01
—
278913
NATIONAL BOARD FOR CERTIFICATION IN OCCUPATIONAL THERAPY
—
01
—
OT-A644
ARKANSAS STATE MEDICIAL BOARD
AR
Enumeration date
10/23/2015
Last updated
11/07/2023
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