Individual
CHELSEA NINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6101 N STATE LINE AVE, TEXARKANA, TX 75503-5309
(903) 791-2270
Mailing address
1362 B K PICKERING DR, TEXARKANA, TX 75501-0906
(903) 733-5275
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
119526
TX
225X00000X
Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
199523721
—
AR
Enumeration date
07/10/2013
Last updated
08/08/2022
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