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Individual

ASIAH ROOT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
24200 W INTERSTATE 10 STE 109, SAN ANTONIO, TX 78257-1150
(210) 263-9443
Mailing address
7418 GREAT LAKES DR, SAN ANTONIO, TX 78244-1345
(830) 330-0153

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
12/28/2023
Last updated
12/28/2023
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