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General NPI Number Information
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NPI Number | 1063705721
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Entity Type | Individual
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Provider Name | VANESSA PRAZERES MACEDO OTR
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Gender | Female
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Dates
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Enumeration Date | 05/27/2011
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Last Update Date | 05/27/2011
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Provider Practice Location Address
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Address Line | 3325 PATE WAY
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City | ANNA
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State | TX
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Zip | 75409-8459
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Country | US
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Telephone | 972-838-2602
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Fax |
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Provider Business Mailing Address
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Address Line | 3721 PINETREE DR
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City | MCKINNEY
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State | TX
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Zip | 75070-7644
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Country | US
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Telephone | 214-864-4027
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 114153
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License Number State | TX
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