Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 106S00000X | Behavior Technician | ||
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 121868 | TX |
NPI | 1366987760 |
---|---|
Provider Name | Megan E Stuva |
First Address | Dallas, TX 75246-1520 |
Second Address | Dallas, TX 75246-1520 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2016 |
Last Update Date | 18/06/2021 |