Individual
MR. BREANNE LANDIVAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
130 SPENCER LN, SAN ANTONIO, TX 78201-2109
(210) 444-9186
Mailing address
130 SPENCER LN, SAN ANTONIO, TX 78201-2109
(210) 444-9186
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
209729
TX
Other
Enumeration date
08/13/2007
Last updated
08/13/2007
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