Individual
GLENNA BETH BORNMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
3617 O HARE DR, MESQUITE, TX 75150-4539
(972) 284-8600
Mailing address
2302 CAMP DAVID ST, MESQUITE, TX 75149-1922
(972) 302-1491
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
106441
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
106441
TEXAS STATE BOARD OF PHYSICAL THERAPY AND OCCUPATIONAL THERAPY EXAMINERS
TX
Enumeration date
08/22/2018
Last updated
08/22/2018
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