Individual
DALLAN ALTAVILA CRUZ CONSTANTINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
77 NORTH EXPY K, BROWNSVILLE, TX 78526-7852
(956) 541-2102
Mailing address
1165 WILDROSE LN APT 116, BROWNSVILLE, TX 78520-8802
(956) 621-8438
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
121810
TX
Other
Enumeration date
06/17/2021
Last updated
06/17/2021
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