Beth Marie Mitts, OTA/L

Individual provider Active NPI Occupational Therapy Assistant · Luling, TX

NPI 1992965529 · NPPES record last updated Jun 17, 2008

Key facts

NPI
1992965529
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
208469 (TX)
Practice address
200 Memorial Dr
Luling, TX 78648-3213
Phone
(830) 875-8457
NPI assigned
Jun 17, 2008
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
208469TXMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 208469 TX Yes

Addresses

Primary practice location

200 Memorial Dr
Luling, TX 78648-3213

Mailing address

200 Memorial Dr
Luling, TX 78648-3213
Phone (830) 875-8457

Other providers in Luling, TX

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

Sources for this page

Verify at the official NPI Registry.