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Individual
MICHELE E PENA
Active
Individual
MICHELE E PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1179690
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1179690
LICENSE
TX
05
—
1992971899
—
TX
Enumeration date
05/01/2008
Last updated
04/17/2019
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