Individual
KASSANDRA SPARKS PRUITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
4362 US HIGHWAY 259 N STE D, LONGVIEW, TX 75605-7674
(903) 212-7716
(903) 663-4833
Mailing address
4362 US HIGHWAY 259 N STE D, LONGVIEW, TX 75605-7674
(903) 212-7716
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
209629
TX
Other
Enumeration date
09/06/2018
Last updated
09/06/2018
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