Morgan Nicole Peden Judice, COTA

Individual provider Active NPI Occupational Therapy Assistant · Kountze, TX

NPI 1013484732 · NPPES record last updated Oct 31, 2018

Key facts

NPI
1013484732
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
214851
Practice address
604 FM 1293 Rd
Kountze, TX 77625-7804
Phone
(409) 658-0961
NPI assigned
Oct 31, 2018
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 214851 Yes

Addresses

Primary practice location

604 FM 1293 Rd
Kountze, TX 77625-7804

Mailing address

1390 Kalas Cir
Lumberton, TX 77657-1172
Phone (409) 658-0961

Other identifiers

IdentifierTypeStateIssuer
214851OtherTXTEXAS BOARD OF OCCUPATIONAL THERAPY EXAMINERS

Other providers in Kountze, TX

All providers in Kountze, TX · Occupational Therapy Assistant in Texas

Sources for this page

Verify at the official NPI Registry.