Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 111331 | TX |
NPI | 1033521547 |
---|---|
Provider Name | Mrs. Michelle Lynn Reed |
First Address | Houston, TX 77019-2717 |
Second Address | Houston, TX 77019-2717 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2014 |
Last Update Date | 02/06/2014 |