Provider Demographics
NPI:1932681434
Name:AGUILERA, CLARA CECILIA
Entity Type:Individual
Prefix:
First Name:CLARA
Middle Name:CECILIA
Last Name:AGUILERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11169 SEAN HAGGERTY DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79934-3385
Mailing Address - Country:US
Mailing Address - Phone:915-849-3000
Mailing Address - Fax:915-821-4339
Practice Address - Street 1:11169 SEAN HAGGERTY DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79934-3385
Practice Address - Country:US
Practice Address - Phone:915-849-3000
Practice Address - Fax:915-821-4339
Is Sole Proprietor?:No
Enumeration Date:2018-08-30
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX210744224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant