Organization
MAGNOLIA PEDIATRIC THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KERRY ANNE O'ROURKE OTR/L (OWNER)
(704) 618-4141
Entity
Organization
Contact information
Practice address
10307 SERENITY SOUND, MAGNOLIA, TX 77354-3238
(704) 618-4141
Mailing address
10307 SERENITY SOUND, MAGNOLIA, TX 77354-3238
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
Other
Enumeration date
03/04/2020
Last updated
06/03/2020
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