Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 100377 | TX |
NPI | 1003250838 |
---|---|
Provider Name | Dr. Jana Karen Cragg |
First Address | San Antonio, TX 78250-4307 |
Second Address | San Antonio, TX 78250-4307 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2013 |
Last Update Date | 23/04/2013 |