Individual
STACY LEANN YOUNGBLOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1323 COUNTY ROAD 202, CARTHAGE, TX 75633-6753
(903) 690-6756
Mailing address
1323 COUNTY ROAD 202, CARTHAGE, TX 75633-6753
(903) 690-6756
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
213272
TX
Other
Enumeration date
07/06/2018
Last updated
07/06/2018
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