Individual
TERESA STANABACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
9441 LBJ FREEWAY, SUITE 602, DALLAS,, TX 75243
(469) 249-1883
(887) 778-7505
Mailing address
10905 NE 48TH ST, KIRKLAND, WA 98033-7704
(409) 392-1105
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
110025
TX
225XP0019X
Physical Rehabilitation Occupational Therapist
OT60579322
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110025
ECPTOTE
TX
01
—
OT 60579322
WASHINGTON STATE DEPARTMENT OF HEALTH
WA
Enumeration date
08/31/2015
Last updated
08/31/2015
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