Provider Demographics
NPI:1699923904
Name:VERDONE, JOSEPHINE (LOTR)
Entity type:Individual
Prefix:MS
First Name:JOSEPHINE
Middle Name:
Last Name:VERDONE
Suffix:
Gender:F
Credentials:LOTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13776 N HIGHWAY 183 STE 107A
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-1875
Mailing Address - Country:US
Mailing Address - Phone:512-827-3670
Mailing Address - Fax:512-777-5042
Practice Address - Street 1:13776 N HIGHWAY 183 STE 107
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-1875
Practice Address - Country:US
Practice Address - Phone:512-827-3670
Practice Address - Fax:512-777-5042
Is Sole Proprietor?:No
Enumeration Date:2008-08-29
Last Update Date:2019-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113999225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist