Provider Demographics
NPI:1194560052
Name:PLACE, EMILY RAE (OTR, OTD)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:RAE
Last Name:PLACE
Suffix:
Gender:F
Credentials:OTR, OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1441 S MIDLOTHIAN PKWY STE 170
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:TX
Mailing Address - Zip Code:76065-5597
Mailing Address - Country:US
Mailing Address - Phone:972-723-0380
Mailing Address - Fax:972-723-0276
Practice Address - Street 1:1441 S MIDLOTHIAN PKWY STE 170
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:TX
Practice Address - Zip Code:76065-5597
Practice Address - Country:US
Practice Address - Phone:972-723-0380
Practice Address - Fax:972-723-0276
Is Sole Proprietor?:No
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX124662225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation