| Mrs Alisa L Larue, OTR | |
|
1030 E Highway 377 Ste 202, Granbury, TX 76048-1460 | |
| (817) 279-6646 | |
| Not Available |
| Full Name | Mrs Alisa L Larue |
|---|---|
| Gender | Female |
| Speciality | Occupational Therapist |
| Location | 1030 E Highway 377 Ste 202, Granbury, Texas |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699912659 | NPI | - | NPPES |
| 822T67 | Other | BLUE CROSS BLUE SHIELD | |
| 201563801 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225X00000X | Occupational Therapist | 111982 (Texas) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Alisa L Larue, OTR 1030 E Highway 377 Ste 202, Granbury, TX 76048-1460 Ph: () - | Mrs Alisa L Larue, OTR 1030 E Highway 377 Ste 202, Granbury, TX 76048-1460 Ph: (817) 279-6646 |
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