Basic Information
| Provider Information | |||||||||
| NPI: | 1720613276 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SOK | ||||||||
| FirstName: | DALIN | ||||||||
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| NamePrefix: | MISS | ||||||||
| NameSuffix: | I | ||||||||
| Credential: | OTA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 305 NE LOOP 820 BUSINESS TOWER 1 | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | HURST | ||||||||
| State: | TX | ||||||||
| PostalCode: | 76053 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | AVEANNA HEALTHCARE 508 W INTERSTATE 2 SUITE 3 | ||||||||
| Address2: | |||||||||
| City: | PHARR | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78577 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9565108777 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/05/2020 | ||||||||
| LastUpdateDate: | 03/05/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/05/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 224Z00000X | 216142 | TX | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant |
No ID Information.