Individual
GENESIS BLANCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14651 DALLAS PKWY STE 200, DALLAS, TX 75254-8856
(214) 690-4607
Mailing address
14651 DALLAS PKWY STE 200, DALLAS, TX 75254-8856
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
218863
TX
Other
Enumeration date
08/07/2025
Last updated
08/07/2025
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