Provider Demographics
NPI:1679048896
Name:ZARICOR, ANITA CAROL (OTR)
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:CAROL
Last Name:ZARICOR
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 1:1229 S HAVEN
Mailing Address - Street 2:
Mailing Address - City:HEWITT
Mailing Address - State:TX
Mailing Address - Zip Code:76643-3967
Mailing Address - Country:US
Mailing Address - Phone:254-715-8885
Mailing Address - Fax:
Practice Address - Street 1:1400 COLLEGE DR
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76708-1499
Practice Address - Country:US
Practice Address - Phone:254-299-8525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-04
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106007225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist