| NPI | 1114484110 |
|---|---|
| Former Name | JACKIE LYNETTE TIJERINA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: CO OT.0005855) |
| Additional Taxonomies | 227900000X Respiratory Therapist, Registered (Licence: CO RTL.0005892) |
| Enumeration Date | 2019-02-26 |
| Last Update Date | 2019-12-27 |