Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | ||
Y | 225XP0200X | Occupational Therapist - Pediatrics |
NPI | 1073080503 |
---|---|
Provider Name | Jessica Nicole Huff |
First Address | Houston, TX 77079-3772 |
Second Address | Houston, TX 77094-1341 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2018 |
Last Update Date | 02/11/2018 |