Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 1330895 | TX |
NPI | 1023626892 |
---|---|
Provider Name | Kylie Mclaughlin |
First Address | Dallas, TX 75251-1455 |
Second Address | Dallas, TX 75251-1455 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2020 |
Last Update Date | 17/07/2020 |