Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 103605 | TX |
NPI | 1114524667 |
---|---|
Provider Name | Cynthia A. Nelson |
First Address | Sadler, TX 76264-3741 |
Second Address | Sadler, TX 76264-3741 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/10/2020 |
Last Update Date | 07/10/2020 |