Individual
IDA LOUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1000 W CROSBY RD STE 136, CARROLLTON, TX 75006-6904
(972) 237-0100
Mailing address
15701 CANYON RDG, PROSPER, TX 75078-1741
(469) 939-3029
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
124873
TX
Other
Enumeration date
03/21/2025
Last updated
03/21/2025
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