Individual
DANIELLE BAHENBURG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2209 RODGERS LN, PROVIDENCE VILLAGE, TX 76227-5770
(817) 705-9445
Mailing address
2209 RODGERS LN, PROVIDENCE VILLAGE, TX 76227-5770
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
123035
TX
Other
Enumeration date
02/14/2025
Last updated
02/14/2025
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