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Organization

BRIDGING THE GAP PEDIATRIC THERAPY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
STACEY KATHLEEN OROSCO OTR (OCCUPATIONAL THERAPIST)
(210) 317-6460
Entity
Organization

Contact information

Practice address
7646 UMBRA HTS, SAN ANTONIO, TX 78252-2256
(210) 317-6460
Mailing address
7646 UMBRA HTS, SAN ANTONIO, TX 78252-2256
(210) 317-6460

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
110793
TX
2355S0801X
Speech-Language Assistant
02995336
TX

Other

Enumeration date
01/20/2012
Last updated
01/24/2012
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