Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 105252 | TX |
NPI | 1194859157 |
---|---|
Provider Name | Cassandra Lou Lewis |
First Address | San Antonio, TX 78201-5621 |
Second Address | San Antonio, TX 78229-4801 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2007 |
Last Update Date | 08/07/2007 |