Individual
JUSTINE RAVEN LUNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
900 WASHINGTON AVE, WACO, TX 76701-1200
(254) 296-9792
Mailing address
1016 S ADAMS ST, MC GREGOR, TX 76657-2357
(254) 242-8337
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
214825
TX
Other
Enumeration date
10/22/2017
Last updated
10/22/2017
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