Individual
JAZMIN BALDERAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
6168 BENTRIDGE DR, HURST, TX 76054-2615
(817) 479-7019
Mailing address
2211 BOMBAY AVE, DALLAS, TX 75235-3514
(972) 391-3550
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
124630
TX
225XP0200X
Pediatric Occupational Therapist
OT21525
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15002128
CAQH PROVIEW
—
Enumeration date
04/22/2021
Last updated
07/22/2024
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