Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 213536 | TX |
NPI | 1609359298 |
---|---|
Provider Name | Heather Anne Ahrendt |
First Address | Lexington, TX 78947-6139 |
Second Address | Caldwell, TX 77836-2328 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2018 |
Last Update Date | 11/09/2018 |