Individual
AILEEN GRACE FORTICH DE GUZMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
3290 N RIDGE RD, SUITE 290, ELLICOTT CITY, MD 21043-3655
(210) 473-9142
Mailing address
26918 REDSTONE HILL, SAN ANTONIO, TX 78261
(830) 438-5955
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
112731
TX
Other
Enumeration date
07/11/2008
Last updated
07/11/2008
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