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General NPI Number Information
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NPI Number | 1518470772
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Entity Type | Individual
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Provider Name | JACQUELINE MARIE ROLLIER OT
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Gender | Female
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Dates
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Enumeration Date | 11/09/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 5323 HARRY HINES BLVD
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City | DALLAS
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State | TX
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Zip | 75390-7201
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Country | US
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Telephone | 214-633-7837
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Fax |
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Provider Business Mailing Address
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Address Line | 4508 SYCAMORE LN
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City | ALLEN
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State | TX
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Zip | 75002-5700
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Country | US
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Telephone | 214-728-4302
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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 | 117556
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License Number State | TX
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