Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 215347 | TX |
NPI | 1023584844 |
---|---|
Provider Name | Kelsey E Garrett |
First Address | Somerville, TX 77879-4519 |
Second Address | College Station, TX 77840-4465 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2018 |
Last Update Date | 18/10/2018 |