Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 120192 | TX |
NPI | 1003467846 |
---|---|
Provider Name | Anna Cecelia Belou |
First Address | New Orleans, LA 70124-3709 |
Second Address | Addison, TX 75001-3549 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2019 |
Last Update Date | 23/09/2019 |