Provider Demographics
NPI:1043996762
Name:QUINTANILLA, ALIA (OTD)
Entity Type:Individual
Prefix:
First Name:ALIA
Middle Name:
Last Name:QUINTANILLA
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2013 BRANDEIS DR
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-4841
Mailing Address - Country:US
Mailing Address - Phone:214-809-9463
Mailing Address - Fax:
Practice Address - Street 1:1245 COLONEL DR
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-1303
Practice Address - Country:US
Practice Address - Phone:972-278-8500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-27
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist