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General NPI Number Information
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NPI Number | 1376110114
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Entity Type | Organization
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Legal Business Name | SELECT REHABILITATION
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Dates
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Enumeration Date | 06/09/2021
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Last Update Date | 06/09/2021
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Provider Practice Location Address
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Address Line | 3690 MAPLESHADE LN
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City | PLANO
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State | TX
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Zip | 75075-5715
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Country | US
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Telephone | 903-868-0593
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Fax |
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Provider Business Mailing Address
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Address Line | 209 RUGBY LN
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City | MCKINNEY
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State | TX
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Zip | 75072-5982
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Country | US
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Telephone | 469-288-1808
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Fax |
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Authorized Official
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Title or Position | COTA. PRN
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Name | MRS. JENNIFER DIANE SMITH-REED
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Credential | COTA
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Telephone | 469-288-1808
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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