Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 110056 | TX |
NPI | 1053878520 |
---|---|
Provider Name | M Hope Parks |
First Address | Allen, TX 75002-2036 |
Second Address | Fort Worth, TX 76135-7025 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2019 |
Last Update Date | 20/02/2019 |