Marilyn Thompson

Individual provider Active NPI Occupational Therapy Assistant · Diboll, TX

NPI 1083115752 · NPPES record last updated Feb 27, 2018

Key facts

NPI
1083115752
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
212452 (TX)
Practice address
906 Denman St
Diboll, TX 75941-1521
Phone
(936) 572-6734
NPI assigned
Feb 27, 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

State licenses

LicenseStateTypeSpecialty
212452TXMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 212452 TX Yes

Addresses

Primary practice location

906 Denman St
Diboll, TX 75941-1521

Mailing address

906 Denman St
Diboll, TX 75941-1521
Phone (936) 572-6734

Other providers in Diboll, TX

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

Sources for this page

Verify at the official NPI Registry.