Organization
LYMPHEDEMA THERAPY SOURCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA SUMMERS OT, CLT-LANA (OWNER/OT, CLT-LANA)
(214) 422-8265
Entity
Organization
Contact information
Practice address
309 W ELDORADO PKWY STE 108, LITTLE ELM, TX 75068-5382
(214) 422-8265
Mailing address
9400 N MACARTHUR BLVD # 124-446, IRVING, TX 75063-4705
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
111147
TX
Other
Enumeration date
05/07/2014
Last updated
04/19/2024
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