Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 211341 | TX |
NPI | 1013491885 |
---|---|
Provider Name | Ms. Lisa Kay Hull |
First Address | San Antonio, TX 78259-3599 |
Second Address | San Antonio, TX 78232-1902 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/09/2018 |
Last Update Date | 18/09/2018 |