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General NPI Number Information
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NPI Number | 1417835505
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Entity Type | Individual
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Provider Name | VANESSA HICIANO
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Gender | Female
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Dates
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Enumeration Date | 08/26/2025
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 12271 COIT RD
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City | DALLAS
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State | TX
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Zip | 75251-2300
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Country | US
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Telephone | 972-866-7575
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Fax |
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Provider Business Mailing Address
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Address Line | 4417 BUNKER HILL RD APT 3307
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City | GARLAND
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State | TX
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Zip | 75048-4997
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Country | US
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Telephone | 973-567-8656
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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 | 125694
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License Number State | TX
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