Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 109866 | TX |
NPI | 1003880998 |
---|---|
Provider Name | Mrs. Lucia Velazquez |
First Address | Mcallen, TX 78503 |
Second Address | Mcallen, TX 78503 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2006 |
Last Update Date | 17/11/2009 |