Healthcare Provider Details

I. General information

NPI: 1134827132
Provider Name (Legal Business Name): INCLUDING YOU THERAPY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2023
Last Update Date: 02/20/2023
Certification Date: 02/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1512 DANDRIDGE DR
CEDAR PARK TX
78613-5459
US

IV. Provider business mailing address

1512 DANDRIDGE DR
CEDAR PARK TX
78613-5459
US

V. Phone/Fax

Practice location:
  • Phone: 512-971-0859
  • Fax:
Mailing address:
  • Phone: 512-971-0859
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MRS. SARAH MCQUEEN
Title or Position: MEMBER/OCCUPATIONAL THERAPIST
Credential: OTR
Phone: 512-971-0859