Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant |
NPI | 1023575362 |
---|---|
Provider Name | Sara Acevedo |
First Address | Waxahachie, TX 75165-1712 |
Second Address | Waxahachie, TX 75165-1712 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2019 |
Last Update Date | 22/02/2019 |