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General NPI Number Information
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NPI Number | 1013171768
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Entity Type | Organization
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Legal Business Name | JUNCTION OF FUNCTION INC
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Dates
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Enumeration Date | 07/11/2008
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Last Update Date | 09/16/2013
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Provider Practice Location Address
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Address Line | 2102 PROMONTORY PT
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City | PLANO
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State | TX
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Zip | 75075-3547
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Country | US
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Telephone | 239-777-4009
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Fax | 972-612-6804
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Provider Business Mailing Address
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Address Line | 2102 PROMONTORY PT
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City | PLANO
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State | TX
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Zip | 75075-3547
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Country | US
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Telephone | 239-777-4009
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Fax | 972-612-6804
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST
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Name | MS. KELLY ANN WILK
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Credential | OTR L
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Telephone | 239-777-4009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 7324
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License Number State | FL
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