Provider Demographics
NPI:1447919949
Name:DOLFORD, DENEA (COTA/L)
Entity type:Individual
Prefix:
First Name:DENEA
Middle Name:
Last Name:DOLFORD
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22101 GRAND CORNER DR APT 13204
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-5951
Mailing Address - Country:US
Mailing Address - Phone:346-285-0817
Mailing Address - Fax:
Practice Address - Street 1:4606 FM 1960 RD W STE 520
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77069-4629
Practice Address - Country:US
Practice Address - Phone:346-333-2794
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-12
Last Update Date:2021-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX217104224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant