Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 213013 | TX |
NPI | 1013387760 |
---|---|
Provider Name | Ruby Friscia |
First Address | Corpus Christi, TX 78411-4324 |
Second Address | Corpus Christi, TX 78411-4324 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2015 |
Last Update Date | 06/10/2015 |