Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 214970 | TX |
NPI | 1023525573 |
---|---|
Provider Name | Jennifer Christine Arriaga |
First Address | Westworth Village, TX 76114-4223 |
Second Address | Fort Worth, TX 76114 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2018 |
Last Update Date | 05/01/2018 |