Individual
MRS. ILIANA A GUILLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
3818 EISENHOWER RD, ODESSA, TX 79762
(432) 978-1374
Mailing address
3818 EISENHOWER RD, ODESSA, TX 79762-6841
(432) 978-1374
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
210836
TX
Other
Enumeration date
05/15/2013
Last updated
05/15/2013
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