Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation |
NPI | 1013497932 |
---|---|
Provider Name | Monica Yvette Perry |
First Address | Beckville, TX 75631-5144 |
Second Address | Longview, TX 75605-7975 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2018 |
Last Update Date | 20/08/2018 |