Individual
MRS. LAURA LEIGH TAKACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
8103 NORTH HOLW, SAN ANTONIO, TX 78240-2387
(210) 558-9001
(210) 558-9010
Mailing address
1815 SOARING EAGLE DR, FISCHER, TX 78623-1809
(830) 708-1256
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
207982
TX
Other
Enumeration date
05/20/2013
Last updated
05/20/2013
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