Healthcare Provider Details

I. General information

NPI: 1669480497
Provider Name (Legal Business Name): JENNIFER R YBARRA OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2109 S K CENTER ST LEGEND TRANSITIONAL CARE CENTER
MCALLEN TX
78503
US

IV. Provider business mailing address

2418 MELROY DRIVE
EDINBURG TX
78539
US

V. Phone/Fax

Practice location:
  • Phone: 956-688-5515
  • Fax: 956-686-9277
Mailing address:
  • Phone: 956-316-4998
  • Fax: 956-618-2439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number261QR0400X
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: