Individual
TANYA MARIE ESCOBAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
4110 GUADALUPE ST, AUSTIN, TX 78751-4223
(512) 751-8525
Mailing address
10607 ARCHDALE DR # NA, AUSTIN, TX 78748-2385
(512) 751-8525
Taxonomy
Speciality
Code
Description
License number
State
225XM0800X
Mental Health Occupational Therapist
Primary
108406
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1014627
NBCOT
MD
01
—
108406
TEXAS BOARD OF OCCUPATIONAL THERAPY EXAMINERS
TX
Enumeration date
03/14/2020
Last updated
03/14/2020
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