Provider Demographics
NPI:1588496939
Name:WINTON, CHARLOTTE LEE (OTA)
Entity type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:LEE
Last Name:WINTON
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 COUNTY ROAD 44100
Mailing Address - Street 2:
Mailing Address - City:POWDERLY
Mailing Address - State:TX
Mailing Address - Zip Code:75473-4725
Mailing Address - Country:US
Mailing Address - Phone:903-782-4380
Mailing Address - Fax:
Practice Address - Street 1:750 N COLLEGIATE DR
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-3465
Practice Address - Country:US
Practice Address - Phone:903-785-1110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-15
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX208052224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant