Provider Demographics
NPI:1578836482
Name:DUCREE, TANYA L (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:TANYA
Middle Name:L
Last Name:DUCREE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1260 PIN OAK RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-6850
Mailing Address - Country:US
Mailing Address - Phone:281-395-5599
Mailing Address - Fax:281-395-5615
Practice Address - Street 1:1260 PIN OAK RD
Practice Address - Street 2:SUITE 108
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-6850
Practice Address - Country:US
Practice Address - Phone:281-395-5599
Practice Address - Fax:281-395-5615
Is Sole Proprietor?:No
Enumeration Date:2012-02-23
Last Update Date:2012-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX114242225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics