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Individual

NISHA DESAI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.T.

Contact information

Practice address
501 S AUSTIN AVE, SUITE 1310, GEORGETOWN, TX 78626-5637
(512) 864-6054
(512) 869-8157
Mailing address
501 S AUSTIN AVE, SUITE 1310, GEORGETOWN, TX 78626-5637
(512) 864-6054
(512) 869-8157

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
111440
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
111440
TX OCCUPATIONAL THERAPY BOARD
TX
Enumeration date
03/23/2010
Last updated
03/23/2010
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