Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 104159 | TX |
NPI | 1720395593 |
---|---|
Provider Name | Mrs. Angela Marie Orengo |
First Address | San Antonio, TX 78217 |
Second Address | San Antonio, TX 78212 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2010 |
Last Update Date | 01/09/2010 |