Individual
MS. IVY MAE BUNACHITA CARRILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
200 N NEW MEXICO DR., CELINA, TX 75009
(214) 851-5555
Mailing address
3912 INDIAN GRASS LN, PROSPER, TX 75078
(661) 472-5413
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
122218
TX
225X00000X
Occupational Therapist
7849
CA
Other
Enumeration date
07/01/2008
Last updated
04/20/2023
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