Provider Demographics
NPI:1093956898
Name:CONTRERAS, GRISEL (OTR)
Entity Type:Individual
Prefix:
First Name:GRISEL
Middle Name:
Last Name:CONTRERAS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:945 S MESA HILLS DR APT 2702
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-5195
Mailing Address - Country:US
Mailing Address - Phone:915-274-3105
Mailing Address - Fax:
Practice Address - Street 1:945 S MESA HILLS DR APT 2702
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-5195
Practice Address - Country:US
Practice Address - Phone:915-274-3105
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-09
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112431225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist