Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 107222 | TX |
N | 225XH1200X | Occupational Therapist - Hand | 1011100545 |
NPI | 1134458458 |
---|---|
Provider Name | Mrs. Mery Cruz Carrera |
First Address | Lumberton, TX 77657-6909 |
Second Address | Beaumont, TX 77706-7078 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2009 |
Last Update Date | 15/12/2009 |