Individual
JEANIE JOE-BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
3640 HAMPTON DR, MISSOURI CITY, TX 77459-3016
(281) 778-5144
Mailing address
23623 CERTOSA DR, RICHMOND, TX 77406-5485
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
208845
TX
Other
Enumeration date
08/15/2018
Last updated
08/15/2018
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