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Individual

GABRIELLE ELISE BOLLETER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
21630 MERCHANTS WAY, KATY, TX 77449-2514
(832) 230-1518
Mailing address
21630 MERCHANTS WAY, KATY, TX 77449-2514
(832) 230-1518

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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