Provider Demographics
NPI:1467922062
Name:FRANCO, JENNIFER (COTA)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:
Last Name:FRANCO
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 CAMARINOS DR
Mailing Address - Street 2:
Mailing Address - City:EAGLE PASS
Mailing Address - State:TX
Mailing Address - Zip Code:78852-5565
Mailing Address - Country:US
Mailing Address - Phone:512-619-2318
Mailing Address - Fax:
Practice Address - Street 1:1003 BECKETT STE 201
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78213-1372
Practice Address - Country:US
Practice Address - Phone:210-998-2330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-27
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX410652224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant