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Individual

ABNY LUBERIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
507 W JACKSON ST, BURNET, TX 78611-3012
(512) 756-6044
Mailing address
805 S VANDEVEER ST APT D, BURNET, TX 78611-3655
(954) 709-9535

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
212779
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
212779
OCCUPATIONAL THERAPY LICENSE
TX
Enumeration date
08/28/2018
Last updated
08/28/2018
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