Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 212657 | TX |
NPI | 1023427374 |
---|---|
Provider Name | Olufemi Adeniji |
First Address | El Paso, TX 79925-2155 |
Second Address | El Paso, TX 79925-2155 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2014 |
Last Update Date | 11/08/2014 |