Individual
MRS. VIRGINIA MARIE HUMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
100 JEFFERY STREET, WACO, TX 76710
(254) 399-6910
Mailing address
1401 OAKLAWN DR, CORSICANA, TX 75110-2823
(903) 215-6199
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
210063
TX
Other
Enumeration date
01/22/2010
Last updated
01/22/2010
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