TARA EZELL WALLACE

MONROE, LA
NPI1265319842
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy224Z00000X Occupational Therapy Assistant
(Licence: LA  OTA.200015)
Enumeration Date2025-08-18
Last Update Date2025-08-18
Business Address
TARA EZELL WALLACE OTA
2301 STERLINGTON RD
MONROE, LA 71203-3045
Phone number: 318-323-3426
Mailing Address
TARA EZELL WALLACE OTA
2301 STERLINGTON RD
MONROE, LA 71203-3045
Phone number: 318-323-3426
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