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Shan Siddiqui, OT

Occupational Therapist in Austin, TX. Individual provider (NPI-1).

NPI number1861963308
StatusActive
Last updated in NPPESDec 10, 2018

Details

NPI
1861963308
Entity type
Individual (NPI-1)
Name
Shan Siddiqui
Credential
OT
Sex
Male
Sole proprietor
No
Enumeration date
Dec 10, 2018
Last updated
Dec 10, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225X00000X Occupational Therapist119141TXYes

Practice location

4607 Manchaca Rd
Austin, TX 78745-1607

Phone 512-916-1511 · Fax 512-916-1532

Mailing address

4607 Manchaca Rd
Austin, TX 78745-1607

Phone 512-916-1511 · Fax 512-916-1532

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