Individual
EDNA MABUTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1020 RALEIGH DR APT 1207, CARROLLTON, TX 75007-7975
(678) 315-8280
Mailing address
1020 RALEIGH DR APT 1207, CARROLLTON, TX 75007-7975
(678) 315-8280
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
120687
TX
Other
Enumeration date
08/27/2020
Last updated
08/27/2020
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