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1932226180
DIANE P. WALLACE
SAN ANTONIO, TX
NPI
1932226180
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: TX 101164)
Enumeration Date
2007-03-23
Last Update Date
2007-07-08
Business Address
-- DIANE P. WALLACE otr
15316 HUEBNER RD SUITE 202
SAN ANTONIO, TX 78248-0987
Phone number: 210-614-4567
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Mailing Address
-- DIANE P. WALLACE otr
15316 HUEBNER RD SUITE 202
SAN ANTONIO, TX 78248-0987
Phone number: 210-614-4567
Copy
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