Provider Demographics
NPI:1922588359
Name:GUERRERO, JULIA LISA (COTA)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:LISA
Last Name:GUERRERO
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 1:1702 MARCHITA AVE
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-2131
Mailing Address - Country:US
Mailing Address - Phone:956-536-8592
Mailing Address - Fax:
Practice Address - Street 1:864 CENTRAL BLVD STE 3200
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-8282
Practice Address - Country:US
Practice Address - Phone:956-280-5491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-15
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX212898224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant