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1801553110
MARIE MACARAEG KOFNOVEC
KELLER, TX
NPI
1801553110
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2080P0008X Pediatrics, Neurodevelopmental Disabilities
(Licence: TX 224Z00000X)
Enumeration Date
2021-11-22
Last Update Date
2021-11-22
Business Address
MARIE MACARAEG KOFNOVEC COTA
630 STONEGLEN DR STE B
KELLER, TX 76248-3626
Phone number: 817-734-6515
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Mailing Address
MARIE MACARAEG KOFNOVEC COTA
5724 HUNTERS BEND LN
DALLAS, TX 75249-2303
Phone number: 972-408-7012
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