Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 117439 | TX |
NPI | 1063901940 |
---|---|
Provider Name | Elizabeth Michelle Hurley |
First Address | Addison, TX 75001-3549 |
Second Address | Addison, TX 75001-3549 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/05/2018 |
Last Update Date | 06/05/2018 |