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General NPI Number Information
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NPI Number | 1194698027
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Entity Type | Individual
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Provider Name | SIRLEY EDIAE OT
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Gender | Female
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Dates
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Enumeration Date | 09/26/2025
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Last Update Date | 10/28/2025
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Provider Practice Location Address
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Address Line | 20320 NORTHWEST FWY STE 400A
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City | JERSEY VILLAGE
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State | TX
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Zip | 77065-5620
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Country | US
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Telephone | 725-209-3053
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Fax | 855-927-7788
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Provider Business Mailing Address
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Address Line | 10680 MEDLOCK BRIDGE RD STE 101
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City | JOHNS CREEK
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State | GA
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Zip | 30097-8420
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Country | US
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Telephone | 725-209-3053
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Fax | 855-927-7788
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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 | 116970
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License Number State | TX
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