Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 369144 | TX |
NPI | 1003353269 |
---|---|
Provider Name | Melanie Joyce Pinkston |
First Address | Hurst, TX 76053-7209 |
Second Address | Tyler, TX 75703-1431 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2017 |
Last Update Date | 26/01/2017 |