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Individual
DR. ABDIEL BOURNE
Active
Individual
DR. ABDIEL BOURNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTD
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
121555
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
121555
EXECUTIVE COUNCIL OF PHYSICAL THERAPY AND OCCUPATIONAL THERAPY EXAMINERS
TX
01
—
446374
NATIONAL BOARD FOR CERTIFICATION IN OCCUPATIONAL THERAPY
MA
Enumeration date
04/03/2021
Last updated
04/03/2021
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