Individual
GABRIELLE ELISE BOLLETER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
225XP0200X
Pediatric Occupational Therapist
122324
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
122324
EXECUTIVE COUNCIL OF PHYSICAL THERAPY AND OCCUPATIONAL THERAPY EXAMINERS
TX
Enumeration date
01/18/2022
Last updated
06/12/2022
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