Individual
MRS. HEATHER RENEE VANCLEAVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1228 LOUANN LANE, TYLER, TX 75701
(903) 539-2267
Mailing address
9979 FM 773, MURCHISON, TX 75778
(903) 288-1546
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
210653
TX
Other
Enumeration date
03/15/2018
Last updated
03/15/2018
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