Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 106586 | TX |
N | 226300000X | Kinesiotherapist | TX |
NPI | 1821441031 |
---|---|
Provider Name | Ms. Stephanie Clare Shoemaker |
First Address | Allen, TX 75002-5357 |
Second Address | Plano, TX 75024 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2016 |
Last Update Date | 22/07/2016 |