Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 224Z00000X | Occupational Therapy Assistant | 057.002694 | IL |
Y | 224Z00000X | Occupational Therapy Assistant | 206703 | TX |
NPI | 1013128172 |
---|---|
Provider Name | Ms. Natalie R Chang-Mason |
First Address | San Antonio, TX 78259-2356 |
Second Address | Fort Sam Houston, TX 78234-4501 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2007 |
Last Update Date | 08/07/2007 |