# DR. ABDIEL BOURNE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1710566286
- **Gender:** Man
- **Credential:** OTD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225X00000X | Occupational Therapist | 121555 | TX | Yes |

## Other

- **Enumeration date:** 04/03/2021
- **Last updated:** 04/03/2021

## 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 |