Individual
STETSON RA'SEAN THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
2010 SW H K DODGEN LOOP, 201, TEMPLE, TX 76504-7062
(254) 774-9991
Mailing address
1071 CLAYTON LN APT 506, AUSTIN, TX 78723-1046
(502) 416-6552
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
212658
TX
Other
Enumeration date
06/23/2014
Last updated
06/23/2014
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