Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 439 | PR |
NPI | 1033325303 |
---|---|
Provider Name | Maribel Boria |
First Address | Gurabo, PR 00778-9532 |
Second Address | San Juan, PR 00922 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2007 |
Last Update Date | 08/07/2007 |