Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225CA2400X | Assistive Technology Practitioner | ATP85924 | TX |
NPI | 1275904757 |
---|---|
Provider Name | Mrs. Maria Lising-Pham I |
First Address | Houston, TX 77099-2400 |
Second Address | Houston, TX 77099-2400 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/10/2015 |
Last Update Date | 09/10/2015 |