Individual
JESSICA NIEVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
6301 GASTON AVE STE 750, DALLAS, TX 75214-3922
(214) 295-5374
Mailing address
2814 SAINT CHARLES DR, MANSFIELD, TX 76063-4069
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
214278
TX
Other
Enumeration date
12/28/2017
Last updated
12/28/2017
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