Individual
CAROLYN MOORE MOHAIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
5316 TRAIL LAKE DR, FORT WORTH, TX 76133-1931
(817) 292-8787
(817) 789-6849
Mailing address
1713 CASTLE CREEK DR, LITTLE ELM, TX 75068-4879
(940) 783-1487
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
101007
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1043583305
NPI#
TX
01
—
1043583305
NPI#
—
Enumeration date
02/17/2012
Last updated
01/19/2018
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