Individual
MS. JACQUELYN M FUENTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
1746 STAR COVE DR, CORPUS CHRISTI, TX 78412-5135
(361) 254-1747
Mailing address
1746 STAR COVE DR, CORPUS CHRISTI, TX 78412-5135
(361) 254-1747
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
210853
TX
Other
Enumeration date
10/10/2022
Last updated
10/10/2022
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