Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 1292599 | TX |
NPI | 1457875270 |
---|---|
Provider Name | Dr. Skye Carmen Braden |
First Address | San Antonio, TX 78258-4072 |
Second Address | San Antonio, TX 78258-4072 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2017 |
Last Update Date | 02/08/2017 |