Healthcare Provider Details

I. General information

NPI: 1477284776
Provider Name (Legal Business Name): EMMA GRACE DAW OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2022
Last Update Date: 09/22/2025
Certification Date: 09/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

171 N GIBSON RD STE 140
HENDERSON NV
89014-6787
US

IV. Provider business mailing address

229 SERENITY CREST ST
HENDERSON NV
89012-5304
US

V. Phone/Fax

Practice location:
  • Phone: 702-360-1137
  • Fax:
Mailing address:
  • Phone: 571-314-7401
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number341445
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number17488
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: