Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225CA2400X | Assistive Technology Practitioner | 91857 | TX |
NPI | 1629678032 |
---|---|
Provider Name | Kelly Ann Blessing |
First Address | Humble, TX 77338-5229 |
Second Address | Humble, TX 77338-5229 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2020 |
Last Update Date | 27/10/2020 |