Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 121807 | TX |
NPI | 1003483868 |
---|---|
Provider Name | Genesis Arreola-Castaneda |
First Address | Lubbock, TX 79424-6019 |
Second Address | Dallas, TX 75212-6313 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2021 |
Last Update Date | 09/06/2021 |