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Individual

ELLIE DZIADUL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2011 BROADWAY ST STE 130, PEARLAND, TX 77581-5945
(281) 997-8509
Mailing address
9006 RUNNING EAGLE FALLS DR, TOMBALL, TX 77375-7097

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
115459
TX

Other

Enumeration date
04/11/2025
Last updated
04/11/2025
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