Tara Licon, OTD

NPI #1255168050 in Buda, Texas

Provider Information

NPI Number: 1255168050
Entity Type: Individual
Name: Tara Licon, OTD
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Occupational Therapist
Credential: OTD
Enumeration Date: Sep 16, 2024
Last Updated: Sep 16, 2024

Practice Location

Address: 1750 FM 967 # A
City: Buda
State: Texas
ZIP Code: 78610-3461
Phone: (512) 295-2273

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X	Primary

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