Supak, Diane Miller

Supak, Diane Miller is an individual health care provider with primary practice located at 457 N Main St , La Grange TX 78945-1937. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as her primary health care specialty. Supak, Diane Miller can be contacted via phone (979) 968-5865.

Contact Information

Primary practice address
457 N Main St La Grange TX 78945-1937
Phone: (979) 968-5865
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X

Profile Details

NPI number 1356824916
LBN Legal business name Supak, Diane Miller
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 10th, 2018
Last updated Sep 10th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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