Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 205907 | TX |
NPI | 1023590577 |
---|---|
Provider Name | Hattie Bee Mason |
First Address | San Antonio, TX 78212-5512 |
Second Address | San Antonio, TX 78212-5512 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2018 |
Last Update Date | 31/08/2018 |