Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225CA2400X | Assistive Technology Practitioner | 5509 |
NPI | 1144596420 |
---|---|
Provider Name | Marlena Sue Nel |
First Address | Spring, TX 77386-1555 |
Second Address | Spring, TX 77386-1555 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2012 |
Last Update Date | 30/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5509 | RESNA ATP (01) |