Individual
MRS. ANNA PUCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
8730 YOUREE DR STE B, SHREVEPORT, LA 71115-2518
(318) 227-9002
Mailing address
8730 YOUREE DR STE B, SHREVEPORT, LA 71115-2518
(318) 227-9002
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
304725
LA
Other
Enumeration date
05/16/2018
Last updated
05/16/2018
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