| NPI | 1174010698 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONETTE, TANGENT HOWARD, JOHNSON Slp/ Otr 832-996-0930 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: TX 116168) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: TX 110782) |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2018-04-19 |
| Last Update Date | 2022-05-02 |