Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 213424 | TX |
NPI | 1003370644 |
---|---|
Provider Name | Elizabeth Torres |
First Address | San Antonio, TX 78249-2032 |
Second Address | San Antonio, TX 78240-1864 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/01/2019 |
Last Update Date | 28/01/2019 |