Individual
COTY SHUPTRINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
3737 N GARLAND AVE, GARLAND, TX 75040-8502
(972) 495-7000
Mailing address
3810 TRANQUILITY LN APT 3206, ROWLETT, TX 75089-0141
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
213966
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
213966
NBOTE
TX
Enumeration date
08/20/2018
Last updated
08/20/2018
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