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General NPI Number Information
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NPI Number | 1942595236
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Entity Type | Individual
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Provider Name | KATRINA CARSON OTA
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Gender | Female
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Dates
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Enumeration Date | 06/14/2011
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Last Update Date | 06/14/2011
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Provider Practice Location Address
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Address Line | 1720 N MCDONALD ST
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City | MCKINNEY
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State | TX
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Zip | 75071-8229
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Country | US
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Telephone | 972-562-7969
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Fax |
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Provider Business Mailing Address
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Address Line | 114 S YOUNG BLVD
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City | DESOTO
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State | TX
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Zip | 75115-5518
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Country | US
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Telephone | 469-765-2289
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 209764
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License Number State | TX
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