Individual
MRS. KEELY BETH SURPRENANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
210265
TX
225X00000X
Occupational Therapist
Primary
118113
TX
Other
Enumeration date
10/07/2008
Last updated
02/01/2017
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