Individual
ALICIA SPENCER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
510 LIBERTY WAY, LAKE DALLAS, TX 75065-3490
(940) 595-0109
Mailing address
510 LIBERTY WAY, LAKE DALLAS, TX 75065-3490
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
209284
TX
Other
Enumeration date
05/16/2010
Last updated
05/16/2010
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