Diane Miller Supak

NPI #1356824916 in La Grange, Texas

Provider Information

NPI Number
1356824916
Entity Type
Individual
Name
Diane Miller Supak
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Occupational Therapist
Enumeration Date
Sep 10, 2018
Last Updated
Sep 10, 2018

Practice Location

Address
457 N MAIN ST
State
Texas
ZIP Code
78945-1937
Phone
(979) 968-5865

Specialties & Taxonomy Codes

Specialty
Occupational Therapist

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