Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 217278 | TX |
NPI | 1003560780 |
---|---|
Provider Name | Lauren Alise Waldrop |
First Address | La Porte, TX 77571-4022 |
Second Address | Pasadena, TX 77504-1960 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2022 |
Last Update Date | 10/02/2022 |