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Individual

MRS. AVERY KRISTIE DE LA PENA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSOT, OTR

Contact information

Practice address
18 SCENIC LOOP RD # 200D, BOERNE, TX 78006-8672
(830) 755-0098
Mailing address
7631 PONDEROSA PNE, BOERNE, TX 78015-5141

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
118625
TX

Other

Enumeration date
09/13/2017
Last updated
05/12/2023
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