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General NPI Number Information
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NPI Number | 1275255093
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Entity Type | Organization
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Legal Business Name | FULL SPECTRUM HEALING LLC
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Dates
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Enumeration Date | 09/19/2022
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Last Update Date | 09/19/2022
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Provider Practice Location Address
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Address Line | 13805 ANN PL
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City | AUSTIN
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State | TX
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Zip | 78728-7702
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Country | US
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Telephone | 737-204-8790
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Fax | 877-839-2838
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Provider Business Mailing Address
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Address Line | 166 HARGRAVES DR. C-400-542
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City | AUSTIN
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State | TX
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Zip | 78737
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Country | US
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Telephone | 737-204-8790
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Fax | 877-839-2838
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Authorized Official
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Title or Position | CEO
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Name | MS. TINA M ANDERSON
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Credential | OTR
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Telephone | 512-538-5748
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XE0001X
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Taxonomy Name | Environmental Modification Occupational Therapist
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License Number |
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Taxonomy #2
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Taxonomy Code | 225XF0002X
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Taxonomy Name | Feeding, Eating & Swallowing Occupational Therapist
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Taxonomy #3
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Taxonomy Code | 225XL0004X
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Taxonomy Name | Low Vision Occupational Therapist
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Taxonomy #4
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Taxonomy Code | 225XM0800X
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Taxonomy Name | Mental Health Occupational Therapist
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Taxonomy #5
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Taxonomy Code | 225XN1300X
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Taxonomy Name | Neurorehabilitation Occupational Therapist
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Taxonomy #6
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Taxonomy Code | 225XP0019X
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Taxonomy Name | Physical Rehabilitation Occupational Therapist
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Taxonomy #7
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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Taxonomy #8
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Taxonomy Code | 225XH1300X
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Taxonomy Name | Human Factors Occupational Therapist
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