Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 118981 | TX |
NPI | 1003396938 |
---|---|
Provider Name | Taylor R Norris |
First Address | Hurst, TX 76053 |
Second Address | Austin, TX 78753-4163 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2018 |
Last Update Date | 20/08/2018 |