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General NPI Number Information
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NPI Number | 1548550593
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Entity Type | Organization
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Legal Business Name | PHYSICAL AND ACADEMIC LEARNING SERVICES, PLLC
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Dates
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Enumeration Date | 04/12/2011
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Last Update Date | 05/23/2011
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Provider Practice Location Address
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Address Line | 1370 FRELSBURG RD
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City | ALLEYTON
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State | TX
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Zip | 78935-2037
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Country | US
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Telephone | 979-732-7021
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Fax | 979-733-9939
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Provider Business Mailing Address
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Address Line | 1370 FRELSBURG RD
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City | ALLEYTON
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State | TX
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Zip | 78935-2037
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Country | US
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Telephone | 979-732-7021
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Fax | 979-733-9939
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | VICKIE MAERTZ
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Credential | OTR/OTD
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Telephone | 979-732-7021
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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 | 553430000
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License Number State | TX
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