Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 108852 | TX |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 108852 | TX |
NPI | 1023395399 |
---|---|
Provider Name | Jenny Kell-Gitchel |
First Address | Dallas, TX 75202-4378 |
Second Address | Dallas, TX 75202-4378 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2011 |
Last Update Date | 16/12/2013 |