Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 208842 | TX |
NPI | 1013191329 |
---|---|
Provider Name | Lorna L Reid |
First Address | Easton, PA 18040-7958 |
Second Address | Dallas, TX 75206-6798 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2007 |
Last Update Date | 21/12/2007 |