Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 113646 | TX |
NPI | 1033584768 |
---|---|
Provider Name | Meredith Simone |
First Address | Frisco, TX 75034-6066 |
Second Address | Frisco, TX 75034-6066 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/12/2015 |
Last Update Date | 07/12/2015 |