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ELIZABETH BALDERAS
>> Occupational Therapy Assistant >> Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersRegistrant NPI Number: 1962084731
Individual Registrant: ELIZABETH BALDERAS
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
2107 DUDLEY ST TEXARKANA, AR 71854-6345 US
Tel: 870-772-4427 Fax: --
Tel: 870-772-4427 Fax: --
Contact information for business:
323 KORNEGAY RD DE QUEEN, AR 71832-8663 US
Tel: 870-613-6611 Fax: --
Tel: 870-613-6611 Fax: --
Registration Information:
NPI: 1962084731
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 224Z00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Occupational Therapy Assistant | TX | 215608 |
| Y | 224Z00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Occupational Therapy Assistant | AR | OT-A1473 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
