Jami Dykes

Individual provider Active NPI Occupational Therapy Assistant · Azle, TX

NPI 1194273375 · NPPES record last updated Dec 4, 2020

Key facts

NPI
1194273375
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
215742 (TX)
Practice address
721 Dunaway LN
Azle, TX 76020-2605
Phone
(817) 444-2536
NPI assigned
Sep 15, 2016
Sex
Female
Sole proprietor
Yes

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
3270MSMDProfessional Counselor
215742TXMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 3270 MS
Occupational Therapy Assistant 224Z00000X 215742 TX Yes

Addresses

Primary practice location

721 Dunaway LN
Azle, TX 76020-2605

Mailing address

4109 Highway 98 W
Summit, MS 39666-9132
Phone (601) 276-3900

Other practice location 1

206 Bay Ave
Richton, MS 39476-2941
Phone (601) 788-6316

Other providers in Azle, TX

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

Sources for this page

Verify at the official NPI Registry.