Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 113013 | TX |
NPI | 1447731203 |
---|---|
Provider Name | Leigh Ellen Garcia |
First Address | Mckinney, TX 75071-3335 |
Second Address | Mckinney, TX 75071-5156 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2018 |
Last Update Date | 28/08/2018 |