Basic Information
| Provider Information | |||||||||
| NPI: | 1265552574 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JAMESON | ||||||||
| FirstName: | SALLY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | OT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1101 E SCHUSTER AVE | ||||||||
| Address2: | |||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 799024659 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9155448484 | ||||||||
| FaxNumber: | 9154960751 | ||||||||
| Practice Location | |||||||||
| Address1: | 1101 E SCHUSTER AVE | ||||||||
| Address2: | |||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 799024659 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9155448484 | ||||||||
| FaxNumber: | 9154960751 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/30/2007 | ||||||||
| LastUpdateDate: | 07/09/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 745 | TX | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.