Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 100134 | TX |
NPI | 1033178116 |
---|---|
Provider Name | Mrs. Lynell Pyle Stover |
First Address | Lufkin, TX 75901 |
Second Address | Lufkin, TX 75901 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2006 |
Last Update Date | 08/07/2007 |