| NPI | 1790674646 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AVERY DE LA PENA Occupational Therapist 830-203-0904 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, |
| 2251P0200X Physical Therapist, Pediatrics | |
| Enumeration Date | 2025-07-02 |
| Last Update Date | 2026-04-13 |