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General NPI Number Information
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NPI Number | 1285960294
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Entity Type | Individual
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Provider Name | FELISHA RENEE DRAKE MOT/OTR
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Gender | Female
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Dates
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Enumeration Date | 10/26/2009
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Last Update Date | 09/10/2012
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Provider Practice Location Address
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Address Line | 1353 N WESTMORELAND
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City | DALLAS
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State | TX
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Zip | 75211
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Country | US
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Telephone | 224-805-7617
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Fax |
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Provider Business Mailing Address
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Address Line | 2502 RIVERSIDE PKWY APT 1324
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City | GRAND PRAIRIE
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State | TX
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Zip | 75050-7985
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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 | 056008573
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 113489
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License Number State | TX
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