Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 108151 | TX |
NPI | 1467692665 |
---|---|
Provider Name | Mr. Mitzi Wells |
First Address | The Woodlands, TX 77384-4100 |
Second Address | The Woodlands, TX 77384-4100 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2009 |
Last Update Date | 27/02/2009 |