Individual
MS. JOANNA HALLEY BACZEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
616 BRUNSWICK DR, LEAGUE CITY, TX 77573-4780
(845) 625-3431
Mailing address
616 BRUNSWICK DR, LEAGUE CITY, TX 77573-4780
(845) 625-3431
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
116440
TX
Other
Enumeration date
02/10/2017
Last updated
02/10/2017
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