Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 216024 | TX |
NPI | 1013553353 |
---|---|
Provider Name | Christina Rubalcava |
First Address | Arlington, TX 76011-4910 |
Second Address | Arlington, TX 76011-4910 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2019 |
Last Update Date | 21/11/2019 |