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Individual

LESLIE PENA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA

Contact information

Practice address
800 S 16TH 1/2 ST, MCALLEN, TX 78501-5263
(956) 328-5424
Mailing address
608 OPUNTIA LN, EDINBURG, TX 78541-1024
(956) 534-3130

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
216513
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
216513
TBOTE
TX
01
443728
NBCOT
TX
Enumeration date
12/08/2020
Last updated
12/08/2020
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