Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 212191 | TX |
NPI | 1003324922 |
---|---|
Provider Name | Cristina Rodriguez |
First Address | Houston, TX 77063-3558 |
Second Address | Houston, TX 77063-3558 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2018 |
Last Update Date | 12/01/2018 |