Individual
JENNIFER VANDEBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1611 HEADWAY CIR BLDG 2, AUSTIN, TX 78754-5165
(512) 478-2581
Mailing address
1611 HEADWAY CIR BLDG 2, AUSTIN, TX 78754-5165
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
113313
TX
Other
Enumeration date
09/30/2009
Last updated
09/30/2009
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