Individual
MRS. ADRIENNE TERESE GAITHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
2203 BABCOCK RD., EASTER SEALS, SAN ANTONIO, TX 78229
(210) 614-3911
Mailing address
11230 ROCKY TRL, SAN ANTONIO, TX 78249-4144
(210) 218-2127
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
107792
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050551331
TAX ID
TX
01
—
8T4121
BLUE CROSS BLUE SHEILD ID
TX
Enumeration date
11/06/2006
Last updated
10/29/2012
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