Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 117514 | TX |
Y | 225XH1200X | Occupational Therapist - Hand | 201911159 | TX |
NPI | 1043838758 |
---|---|
Provider Name | Jana Crook Junek |
First Address | Lyons, TX 77863-0356 |
Second Address | College Station, TX 77845-6099 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2020 |
Last Update Date | 09/07/2020 |