Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 1176159 | TX |
NPI | 1346721065 |
---|---|
Provider Name | Anne Stuifbergen Morales |
First Address | Austin, TX 78748-2061 |
Second Address | Austin, TX 78748-3614 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2018 |
Last Update Date | 22/08/2018 |