Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 109661 | TX |
NPI | 1992993505 |
---|---|
Provider Name | Wendy Hartson |
First Address | San Antonio, TX 78240-1669 |
Second Address | San Antonio, TX 78240-1669 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/10/2007 |
Last Update Date | 29/09/2015 |