Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 005663 | TX |
NPI | 1073941290 |
---|---|
Provider Name | Ms. Lizette Taylor |
First Address | Arlington, TX 76001-2909 |
Second Address | Arlington, TX 76001-2909 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2013 |
Last Update Date | 25/10/2013 |