Provider Demographics
NPI:1710421441
Name:GUEVARA, ORQUIDANIA (COTA)
Entity Type:Individual
Prefix:MRS
First Name:ORQUIDANIA
Middle Name:
Last Name:GUEVARA
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 1:1008 LAWNDALE ST
Mailing Address - Street 2:
Mailing Address - City:CELINA
Mailing Address - State:TX
Mailing Address - Zip Code:75009-1789
Mailing Address - Country:US
Mailing Address - Phone:973-870-8297
Mailing Address - Fax:
Practice Address - Street 1:9966 LEGACY DR
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-6732
Practice Address - Country:US
Practice Address - Phone:214-494-4264
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-14
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX215685224Z00000X
NJ46TA09132600224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant