Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XG0600X | Occupational Therapist - Gerontology |
NPI | 1104113992 |
---|---|
Provider Name | Maria Eugenia Riestra-Cruz |
First Address | San Antonio, TX 78244-1206 |
Second Address | San Antonio, TX 78244-1206 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2011 |
Last Update Date | 11/07/2011 |