MEDICARE: CHRISTINA COMLEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	224Z00000X	Occupational Therapy Assistant

General Provider Information

NPI Number	:	1447967823
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA COMLEY

Provider Business Mailing Address
First Line	:	801 LEGACY DR APT 1023
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75023-2222
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3800 W PARK BLVD
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75075-3542
Country	:	US
Telephone Number	:	972-612-1700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/03/2022
Last Update Date	:	11/03/2022

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Directions to “ CHRISTINA COMLEY ” Practice Location

Language	Start Address	Practice Location

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