Healthcare Provider Details

I. General information

NPI: 1851889067
Provider Name (Legal Business Name): VICTORIA MICHELLE CORRIGAN MOT, OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2018
Last Update Date: 04/22/2021
Certification Date: 04/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20639 KUYKENDAHL RD STE 200
SPRING TX
77379-3587
US

IV. Provider business mailing address

20639 KUYKENDAHL RD STE 200
SPRING TX
77379-3587
US

V. Phone/Fax

Practice location:
  • Phone: 832-698-0111
  • Fax:
Mailing address:
  • Phone: 832-698-0111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number121666
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: