Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 210268 | TX |
NPI | 1013499508 |
---|---|
Provider Name | Nancy Alondra Escamilla |
First Address | Mission, TX 78573-1418 |
Second Address | Alamo, TX 78516 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2018 |
Last Update Date | 31/08/2018 |