Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 109855 | TX |
N | 225XM0800X | Mental Health | 109855 | TX |
NPI | 1588692016 |
---|---|
Provider Name | Mrs. Tara C Alexander |
First Address | Allen, TX 75013-6325 |
Second Address | Dallas, TX 75216 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2006 |
Last Update Date | 24/12/2009 |