Individual
JAN A MOBLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3200 TROUP HWY STE 333, TYLER, TX 75701-8343
(903) 535-5055
Mailing address
3200 TROUP HWY STE 333, TYLER, TX 75701-8343
(903) 535-5055
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
104899
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104899
STATE LICENSE
TX
Enumeration date
03/21/2007
Last updated
07/08/2007
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