Individual
TAYLOR NICOLE SAMPLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6301 GASTON AVE STE 750, DALLAS, TX 75214-6339
(214) 295-5374
Mailing address
2974 FM 66, WAXAHACHIE, TX 75167-8415
(972) 825-6899
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
216081
TX
Other
Enumeration date
01/15/2020
Last updated
01/15/2020
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