Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 218 | MT |
NPI | 1114219482 |
---|---|
Provider Name | Ms. Patricia Gail Welling |
First Address | Athens, TN 37303 |
Second Address | Irving, TX 75063-2414 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2011 |
Last Update Date | 05/05/2011 |