Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 209590 | TX |
NPI | 1033280482 |
---|---|
Provider Name | Denise Hernandez |
First Address | Alamo, TX 78516-9369 |
Second Address | Pharr, TX 78577-3124 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2006 |
Last Update Date | 08/07/2007 |