Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 110304 | TX |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 110304 | TX |
Y | 225XP0200X | Occupational Therapist - Pediatrics | 110304 | TX |
NPI | 1497884829 |
---|---|
Provider Name | Mrs. Jill Deborah Rives |
First Address | Katy, TX 77494-2220 |
Second Address | Katy, TX 77494-2220 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2007 |
Last Update Date | 18/02/2010 |