Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 103648 | TX |
NPI | 1033521232 |
---|---|
Provider Name | Colene Ripley |
First Address | Jersey Village, TX 77040-1114 |
Second Address | Jersey Village, TX 77040-1114 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2014 |
Last Update Date | 22/05/2014 |