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General NPI Number Information
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NPI Number | 1639890734
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Entity Type | Individual
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Provider Name | BARRIE LYNN LAND
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Gender | Female
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Dates
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Enumeration Date | 09/07/2022
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Last Update Date | 09/07/2022
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Provider Practice Location Address
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Address Line | 11110 TOM ADAMS DR
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City | AUSTIN
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State | TX
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Zip | 78753-3354
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Country | US
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Telephone | 844-960-5295
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Fax |
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Provider Business Mailing Address
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Address Line | 215 HYLTIN ST
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City | HUTTO
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State | TX
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Zip | 78634-5324
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Country | US
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Telephone | 512-818-7948
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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 | 224ZR0403X
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Taxonomy Name | Driving and Community Mobility Occupational Therapy Assistant
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License Number | 211766
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License Number State | TX
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