Provider Demographics
NPI:1932416989
Name:PRATHER, CHARITY (OTR)
Entity Type:Individual
Prefix:
First Name:CHARITY
Middle Name:
Last Name:PRATHER
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 1:2502 ATLANTIC VW
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78415-1422
Mailing Address - Country:US
Mailing Address - Phone:260-609-2101
Mailing Address - Fax:
Practice Address - Street 1:2502 ATLANTIC VW
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78415-1422
Practice Address - Country:US
Practice Address - Phone:260-609-2101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-10
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX121248225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation