Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 214444 | TX |
NPI | 1003375700 |
---|---|
Provider Name | Haley Leann Michael |
First Address | Paris, TX 75460-2219 |
Second Address | Paris, TX 75460-2219 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2019 |
Last Update Date | 13/03/2019 |