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General NPI Number Information
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NPI Number | 1326389685
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Entity Type | Individual
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Provider Name | ELIZABETH ROSE HANUSHEK
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Gender | Female
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Dates
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Enumeration Date | 03/12/2013
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Last Update Date | 03/12/2013
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Provider Practice Location Address
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Address Line | 112 SW 8TH AVE STE 301
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City | AMARILLO
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State | TX
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Zip | 79101-2315
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Country | US
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Telephone | 806-350-6793
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Fax |
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Provider Business Mailing Address
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Address Line | 3211 30TH ST
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City | LUBBOCK
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State | TX
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Zip | 79410-3105
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Country | US
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Telephone | 501-733-2900
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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 | 114213
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License Number State | TX
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