Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 215376 | TX |
NPI | 1003397472 |
---|---|
Provider Name | Katie Frances Hall |
First Address | Daingerfield, TX 75638-5935 |
Second Address | Hughes Springs, TX 75656-6993 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2018 |
Last Update Date | 23/08/2018 |