Individual
JILL R MOELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
6912 RAIN CREEK PKWY, AUSTIN, TX 78759-7038
(512) 338-4022
(512) 338-4022
Mailing address
6912 RAIN CREEK PKWY, AUSTIN, TX 78759-7038
(512) 338-4022
(512) 338-4022
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
109371
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
109371
STATE BOARD
TX
01
—
8T0090
BCBS
TX
Enumeration date
09/20/2006
Last updated
04/14/2008
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