Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 117201 | TX |
NPI | 1326418625 |
---|---|
Provider Name | Theresa Mclaughlin |
First Address | Roswell, GA 30076-3493 |
Second Address | Omaha, NE 68154-4407 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2015 |
Last Update Date | 06/01/2022 |