Individual
MRS. MICKAELA MUNOZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
409 4TH ST, BOVINA, TX 79009-0093
(575) 791-5063
Mailing address
PO BOX 93, BOVINA, TX 79009-0093
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
210586
TX
Other
Enumeration date
07/18/2014
Last updated
07/18/2014
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