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NPI 1902246176

NPI 1902246176 : PATRICE DEANAE WASHINGTON MOT, OTR/L : DALLAS, TX

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General NPI Number Information
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    NPI Number           |    1902246176
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    Entity Type          |    Individual 
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    Provider Name        |    PATRICE DEANAE WASHINGTON MOT, OTR/L
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/02/2013
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    Last Update Date     |    07/02/2013
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Provider Practice Location Address
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    Address Line         |    5201 HARRY HINES BLVD 
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    City                 |    DALLAS
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    State                |    TX
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    Zip                  |    75235-7708
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    Country              |    US
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    Telephone            |    214-590-8000
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    7575 FRANKFORD RD APT 2511
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    City                 |    DALLAS
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    State                |    TX
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    Zip                  |    75252-6459
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    Country              |    US
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    Telephone            |    816-868-1527
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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       |    114686
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    License Number State |    TX
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