Individual
CAROLYN PAT MCGOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
106399
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
181921101
—
TX
01
—
8T5487
BCBS OF TX PROV ID
TX
Enumeration date
05/15/2007
Last updated
04/30/2010
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