Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 214027 | TX |
NPI | 1639709181 |
---|---|
Provider Name | Jessica Ann Davis-Ramos |
First Address | Leander, TX 78641-2750 |
Second Address | Leander, TX 78641-2750 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2020 |
Last Update Date | 23/01/2020 |