Individual
DONAVON JACOB RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
9244 GATEWAY BLVD E STE AB, EL PASO, TX 79907-1845
(915) 213-5490
Mailing address
9516 ROANOKE DR, EL PASO, TX 79924-6210
(915) 478-0649
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
216126
TX
Other
Enumeration date
05/14/2025
Last updated
05/14/2025
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