Individual
YAHEIYA SHARONDELE MCCLENDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA / L
Contact information
Practice address
3235 N WILLOWOOD LN, BEAUMONT, TX 77703-2645
(409) 600-7677
Mailing address
3235 N WILLOWOOD LN, BEAUMONT, TX 77703-2645
(409) 600-7677
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
213584
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
SELF
TX
Enumeration date
07/18/2019
Last updated
07/18/2019
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