Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 208762 | TX |
NPI | 1013175496 |
---|---|
Provider Name | Ms. Janice Martinez Hernandez |
First Address | San Antonio, TX 78229-4402 |
Second Address | San Antonio, TX 78229-4402 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2008 |
Last Update Date | 02/06/2008 |