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General NPI Number Information
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NPI Number | 1679304588
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Entity Type | Individual
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Provider Name | EMILY ROSE HUNTER OTR
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Gender | Female
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Dates
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Enumeration Date | 08/12/2024
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Last Update Date | 08/12/2024
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Provider Practice Location Address
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Address Line | 16415 ADDISON RD STE 150
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City | ADDISON
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State | TX
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Zip | 75001-5331
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Country | US
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Telephone | 208-215-5518
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Fax |
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Provider Business Mailing Address
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Address Line | 3900 GRAPEVINE MILLS PKWY UNIT 1927
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City | GRAPEVINE
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State | TX
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Zip | 76051-0910
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Country | US
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Telephone | 208-215-5518
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 124471
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License Number State | TX
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