Provider Demographics
NPI:1699256909
Name:SWILLEY, PAULA DAWN (COTA)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:DAWN
Last Name:SWILLEY
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7247 STRICKLAND SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:TX
Mailing Address - Zip Code:75672-5931
Mailing Address - Country:US
Mailing Address - Phone:903-930-6199
Mailing Address - Fax:903-633-2800
Practice Address - Street 1:7247 STRICKLAND SPRINGS RD
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:TX
Practice Address - Zip Code:75672
Practice Address - Country:US
Practice Address - Phone:903-930-6199
Practice Address - Fax:903-930-2800
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-24
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX209087224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant