Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 216278 | TX |
NPI | 1023771409 |
---|---|
Provider Name | Nicole C Mcnair |
First Address | San Antonio, TX 78259-3690 |
Second Address | San Antonio, TX 78240-1201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2021 |
Last Update Date | 21/10/2021 |