Individual
ELIZABETH BANUELOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
815 E GRAYSON ST, SAN ANTONIO, TX 78208-1014
(210) 226-8181
Mailing address
815 E GRAYSON ST, SAN ANTONIO, TX 78208-1014
(210) 226-8181
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
203584
TX
Other
Enumeration date
08/26/2018
Last updated
08/26/2018
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