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General NPI Number Information
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NPI Number | 1033666508
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Entity Type | Individual
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Provider Name | DARLENE DEGRAND
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Gender | Female
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Dates
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Enumeration Date | 09/01/2016
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Last Update Date | 09/01/2016
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Provider Practice Location Address
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Address Line | 6803 N NAVARRO ST APT 180
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City | VICTORIA
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State | TX
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Zip | 77904-1528
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Country | US
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Telephone | 956-345-5812
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Fax | 361-576-3304
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Provider Business Mailing Address
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Address Line | 6803 N NAVARRO ST APT # 180
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City | VICTORIA
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State | TX
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Zip | 77904-1528
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Country | US
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Telephone | 361-576-3304
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Fax | 361-576-3304
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 208472
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License Number State | TX
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