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General NPI Number Information
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NPI Number | 1871234112
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Entity Type | Individual
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Provider Name | ERYN TRACY OTD, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 04/01/2022
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Last Update Date | 04/01/2022
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Provider Practice Location Address
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Address Line | 909 N WASHINGTON AVE
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City | DALLAS
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State | TX
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Zip | 75246-1520
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Country | US
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Telephone | 214-820-9300
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Fax |
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Provider Business Mailing Address
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Address Line | 1551 OAK LAWN AVE APT 112
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City | DALLAS
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State | TX
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Zip | 75207-3619
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Country | US
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Telephone | 501-580-6410
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 121252
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License Number State | TX
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