Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 119207 | TX |
NPI | 1003390824 |
---|---|
Provider Name | Swadhi Pillai |
First Address | Southlake, TX 76092-9758 |
Second Address | Southlake, TX 76092-5236 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/09/2018 |
Last Update Date | 18/09/2018 |