Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 109538 | TX |
Y | 225XP0200X | Occupational Therapist - Pediatrics | 109538 | TX |
NPI | 1003979832 |
---|---|
Provider Name | Laura F Daggs |
First Address | Hurst, TX 76053 |
Second Address | Hurst, TX 76053 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2006 |
Last Update Date | 10/03/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
005722601 | (05) | TX |