Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 1057522 | OR |
N | 224Z00000X | Occupational Therapy Assistant | 1136 | CT |
N | 224Z00000X | Occupational Therapy Assistant | 209048 | TX |
N | 224Z00000X | Occupational Therapy Assistant | 3318 | MA |
NPI | 1003114364 |
---|---|
Provider Name | Margaret Ann Munroe |
First Address | Longview, TX 75604-2148 |
Second Address | Longview, TX 75604-2148 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2011 |
Last Update Date | 09/03/2011 |