Provider Demographics
NPI:1689992257
Name:KILLIAN, DALENE MARIE (OTR)
Entity Type:Individual
Prefix:
First Name:DALENE
Middle Name:MARIE
Last Name:KILLIAN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3838 N BRAESWOOD BLVD APT 245
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-3018
Mailing Address - Country:US
Mailing Address - Phone:713-202-0207
Mailing Address - Fax:
Practice Address - Street 1:11777 KATY FWY STE 260
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-1703
Practice Address - Country:US
Practice Address - Phone:281-558-5437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-06
Last Update Date:2010-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113864225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist