Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 350 | PR |
N | 2251E1200X | Ergonomics | 350 | PR |
N | 225XE1200X | Ergonomics | 350 | PR |
N | 225XH1200X | Occupational Therapist - Hand | 350 | PR |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 350 | PR |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 350 | PR |
NPI | 1366001356 |
---|---|
Provider Name | Mrs. Maria Elena Roman |
First Address | Quebradillas, PR 00678-1084 |
Second Address | Quebradillas, PR 00678 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2019 |
Last Update Date | 12/06/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100004471 | CFSE (01) | PR |