Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 101895 | TX |
NPI | 1003951559 |
---|---|
Provider Name | Ms. Margaret Luckenbach Brown |
First Address | Georgetown, TX 78628-2923 |
Second Address | Georgetown, TX 78628-8835 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2007 |
Last Update Date | 08/07/2007 |