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Individual

PATRICIA GEORGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
107 WOODBINE PL, #775, LONGVIEW, TX 75601-2912
(903) 237-2315
Mailing address
107 WOODBINE PL, #775, LONGVIEW, TX 75601-2912

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
106866
TX
225XP0200X
Pediatric Occupational Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
106866
TX
Enumeration date
04/15/2015
Last updated
05/20/2016
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