Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 403547 | TX |
NPI | 1013115211 |
---|---|
Provider Name | Dayna Rodriguez |
First Address | Amarillo, TX 79106-5016 |
Second Address | Amarillo, TX 79106-2110 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2007 |
Last Update Date | 10/07/2007 |