Mary Ellen Elder, OTR/L

Individual provider Active NPI Occupational Therapist · Seminole, TX

NPI 1992991889 · NPPES record last updated Oct 29, 2021

Key facts

NPI
1992991889
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
114224 (TX)
Practice address
500 SW 19TH St
Seminole, TX 79360-3806
Phone
(575) 706-5923
Fax
(432) 523-1903
NPI assigned
Sep 24, 2007
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
1961NMMDOccupational Therapist
114224TXMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 1961 NM
Occupational Therapist 225X00000X 114224 TX Yes

Addresses

Primary practice location

500 SW 19TH St
Seminole, TX 79360-3806

Mailing address

500 SW 19TH St
Seminole, TX 79360-3806
Phone (575) 706-5923

Other providers in Seminole, TX

All providers in Seminole, TX · Occupational Therapist in Texas

Sources for this page

Verify at the official NPI Registry.