Provider Demographics
NPI:1386680395
Name:CAFIERO, MARY ALICE (MSOTR, ATP)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:ALICE
Last Name:CAFIERO
Suffix:
Gender:F
Credentials:MSOTR, ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1710 WOODCREEK DR
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-4525
Mailing Address - Country:US
Mailing Address - Phone:972-757-3733
Mailing Address - Fax:888-708-8683
Practice Address - Street 1:1710 WOODCREEK DR
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75082-4525
Practice Address - Country:US
Practice Address - Phone:972-757-3733
Practice Address - Fax:888-708-8683
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-20
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX005088225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX612202Medicare ID - Type UnspecifiedMEDICARE PART B