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Individual

LAURA LYNN BEACH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
1022 STATE HIGHWAY 21 E, CALDWELL, TX 77836-4611
(979) 567-8408
Mailing address
1022 STATE HIGHWAY 21 E, CALDWELL, TX 77836-4611
(979) 567-8408

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
2010026802
MO
224Z00000X
Occupational Therapy Assistant
Primary
211157
TX
224Z00000X
Occupational Therapy Assistant
4730-027
WI

Other

Enumeration date
04/25/2011
Last updated
04/25/2011
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