Basic Information
| Provider Information | |||||||||
| NPI: | 1851531917 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | DYE | ||||||||
| FirstName: | LESLIE | ||||||||
| MiddleName: | GAIL | ||||||||
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| Credential: | O.T.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 805 N 7TH ST | ||||||||
| Address2: | |||||||||
| City: | SANGER | ||||||||
| State: | TX | ||||||||
| PostalCode: | 762664203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9404536218 | ||||||||
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| Practice Location | |||||||||
| Address1: | 901 SEVEN OAKS RD | ||||||||
| Address2: | |||||||||
| City: | BONHAM | ||||||||
| State: | TX | ||||||||
| PostalCode: | 754183237 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9035832191 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/03/2009 | ||||||||
| LastUpdateDate: | 11/02/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 224Z00000X | 208132 | TX | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant |
No ID Information.