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General NPI Number Information
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NPI Number | 1114375441
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Entity Type | Individual
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Provider Name | KATHARINE ROWLAND GREVERA
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Gender | Female
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Dates
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Enumeration Date | 05/26/2016
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Last Update Date | 02/20/2018
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Provider Practice Location Address
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Address Line | 105 EAGLE CV
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City | LAKEWAY
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State | TX
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Zip | 78734-5010
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Country | US
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Telephone | 512-520-6598
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Fax |
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Provider Business Mailing Address
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Address Line | 3307 NORTHLAND DR STE 470
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City | AUSTIN
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State | TX
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Zip | 78731-4943
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Country | US
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Telephone |
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Fax |
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 106088
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License Number State | TX
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