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Individual

DOMINAE BEAVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
2900 STILLHOUSE RD, PARIS, TX 75462-2029
(903) 785-1601
Mailing address
336 COUNTY RD 2455, CLARKSVILLE, TX 75426

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
217012
TX

Other

Enumeration date
02/21/2022
Last updated
02/21/2022
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