Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 682 | OK |
NPI | 1104994482 |
---|---|
Provider Name | Ms. Patricia O. Braught Hull |
First Address | Dallas, TX 75261-2430 |
Second Address | Poteau, OK 74953-4102 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2006 |
Last Update Date | 08/07/2007 |