Individual
MRS. IVETTE ANGELICA NIENSTEDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4095 DEZAVALA RD, SHAVANO PARK, TX 78249-2066
(210) 493-8100
(210) 493-8154
Mailing address
4095 DEZAVALA RD, SHAVANO PARK, TX 78249-2066
(210) 493-8100
(210) 493-8154
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
105472
TX
Other
Enumeration date
05/15/2008
Last updated
05/15/2008
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