Individual
MRS. KRYSTAL CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9441 LBJ FWY, SUITE 101, DALLAS, TX 75243-4545
(214) 575-9820
Mailing address
9441 LBJ FWY, SUITE 101, DALLAS, TX 75243-4545
(214) 575-9820
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
209906
TX
Other
Enumeration date
04/18/2008
Last updated
04/18/2008
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