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General NPI Number Information
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NPI Number | 1215454921
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Entity Type | Organization
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Legal Business Name | MY COMFORT ZONE LLC
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Dates
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Enumeration Date | 08/23/2017
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Last Update Date | 07/26/2023
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Provider Practice Location Address
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Address Line | 2521 KATES PL
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City | PROSPER
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State | TX
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Zip | 75078-3256
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Country | US
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Telephone | 954-873-7101
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Fax |
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Provider Business Mailing Address
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Address Line | 2521 KATES PL
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City | PROSPER
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State | TX
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Zip | 75078-3256
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Country | US
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Telephone | 954-873-7101
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Fax |
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Authorized Official
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Title or Position | OWNER/OCCUPATIONAL THERAPIST
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Name | TAMARA ANTONINO
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Credential | OTR, OTD
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Telephone | 954-873-7101
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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 |
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License Number State |
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