Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 117403 | TX |
NPI | 1225517139 |
---|---|
Provider Name | Anna Elizabeth Dobraski |
First Address | Spring, TX 77389-4969 |
Second Address | Spring, TX 77389-4969 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2018 |
Last Update Date | 10/08/2018 |