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General NPI Number Information
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NPI Number | 1689027732
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Entity Type | Organization
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Legal Business Name | PATHWAYS TO INDEPENDENCE, INC.
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Dates
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Enumeration Date | 07/13/2016
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Last Update Date | 07/13/2016
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Provider Practice Location Address
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Address Line | 2700 TIBBETS DR STE 301
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City | BEDFORD
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State | TX
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Zip | 76022-5928
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Country | US
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Telephone | 469-662-8224
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Fax |
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Provider Business Mailing Address
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Address Line | 2700 TIBBETS DR STE 301
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City | BEDFORD
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State | TX
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Zip | 76022-5928
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/OCCUPATIONAL THERAPIST
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Name | MRS. DIANA BRITT
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Credential | OTR
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Telephone | 469-662-8224
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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 | 108146
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License Number State | TX
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