Whitney Evans, L/COTA

Individual provider Active NPI Occupational Therapy Assistant · Italy, TX

NPI 1174005656 · NPPES record last updated Aug 31, 2018

Key facts

NPI
1174005656
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
213559 (TX)
Practice address
220 Davenport
Italy, TX 76651-3592
Phone
(972) 483-6369
NPI assigned
Aug 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

State licenses

LicenseStateTypeSpecialty
213559TXMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 213559 TX Yes

Addresses

Primary practice location

220 Davenport
Italy, TX 76651-3592

Mailing address

128 Park Crest Dr
Red Oak, TX 75154-5114
Phone (469) 245-6945

Other providers in Italy, TX

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

Sources for this page

Verify at the official NPI Registry.