Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 115877 | TX |
N | 225XF0002X | Feeding, Eating & Swallowing | ||
N | 225XP0200X | Occupational Therapist - Pediatrics |
NPI | 1619494069 |
---|---|
Provider Name | Kara Michael |
First Address | Beaumont, TX 77706-4110 |
Second Address | Beaumont, TX 77706-4110 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2017 |
Last Update Date | 26/08/2017 |