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1679519078
LARA KRISTINE BLACK
SAN ANTONIO, TX
NPI
1679519078
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225XP0200X Occupational Therapist, Pediatrics
(Licence: TX 109710)
Enumeration Date
2006-06-22
Last Update Date
2007-07-08
Business Address
-- LARA KRISTINE BLACK OT
227 W DREXEL AVE
SAN ANTONIO, TX 78210-2912
Phone number: 210-731-1300
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Mailing Address
-- LARA KRISTINE BLACK OT
3031 IH 10 W
SAN ANTONIO, TX 78201-5159
Phone number:
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