Individual
LAQUITA STREETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
404 RACQUET CLUB BLVD, BEDFORD, TX 76022-6408
(682) 738-3056
Mailing address
302 STARLIGHT DR, YAZOO CITY, MS 39194-8549
(662) 763-8352
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
216448
TX
224Z00000X
Occupational Therapy Assistant
OTA-2943
MS
Other
Enumeration date
03/08/2021
Last updated
03/08/2021
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