Individual
LAURA DY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3551 ROGER BROOKE DR, SAN ANTONIO, TX 78234-4504
(773) 517-5724
Mailing address
1585 3RD ST, FORT POLK, LA 71459-5102
(773) 517-5724
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056009317
IL
225X00000X
Occupational Therapist
—
—
Other
Enumeration date
12/20/2011
Last updated
02/27/2024
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