Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 104896 | TX |
NPI | 1003025859 |
---|---|
Provider Name | Mrs. Cynthia Beniker Knapp |
First Address | League City, TX 77573-4373 |
Second Address | League City, TX 77573-4373 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2007 |
Last Update Date | 08/07/2007 |