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General NPI Number Information
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NPI Number | 1720335508
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Entity Type | Individual
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Provider Name | OLGA MARINA DUNCAN LICENSED COTA
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Gender | Female
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Dates
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Enumeration Date | 08/10/2012
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Last Update Date | 08/23/2018
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Provider Practice Location Address
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Address Line | 22211 BOULDER SPRINGS LN
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City | TOMBALL
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State | TX
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Zip | 77375
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Country | US
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Telephone | 281-468-5828
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Fax |
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Provider Business Mailing Address
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Address Line | 22211 BOULDER SPRINGS LN
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City | TOMBALL
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State | TX
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Zip | 77375-2247
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Country | US
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Telephone | 281-467-5828
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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 | 171W00000X
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Taxonomy Name | Contractor
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License Number | 209753
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 209753
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License Number State | TX
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