Griselda Blanco, OTR

Individual provider Active NPI Occupational Therapist · Rio Grande City, TX

NPI 1003101445 · NPPES record last updated Nov 4, 2023

Key facts

NPI
1003101445
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
114169 (TX)
Practice address
5346 E US Highway 83 Ste 2
Rio Grande City, TX 78582-9418
Phone
(956) 317-1282
Fax
(956) 317-1282
NPI assigned
Jun 14, 2011
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Mind Over Matter Pediatric Therapy Center, LLC Occupational Therapist Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 114169 TX Yes

Addresses

Primary practice location

5346 E US Highway 83 Ste 2
Rio Grande City, TX 78582-9418

Mailing address

5346 E US Highway 83 Ste 2
Rio Grande City, TX 78582-9418
Phone (956) 292-1700

Other identifiers

IdentifierTypeStateIssuer
460581169MedicaidTX
270385434MedicaidTX
270230249MedicaidTX
862263137MedicaidTX

Other providers in Rio Grande City, TX

All providers in Rio Grande City, TX · Occupational Therapist in Texas

Sources for this page

Verify at the official NPI Registry.