Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 106204 | TX |
N | 225XP0200X | Occupational Therapist - Pediatrics | 106204 | TX |
NPI | 1790861433 |
---|---|
Provider Name | Ms. Christa Rae Simmons |
First Address | Austin, TX 78751-1073 |
Second Address | Austin, TX 78751-1073 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2006 |
Last Update Date | 10/01/2013 |