Individual
CECILIA FASANELLA PENNEKAMP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
10839 QUARRY PARK, SAN ANTONIO, TX 78233-4681
(102) 576-2602
(210) 451-8058
Mailing address
10839 QUARRY PARK, SAN ANTONIO, TX 78233-4681
(210) 257-6260
(210) 451-8058
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
116910
TX
225X00000X
Occupational Therapist
1470
ID
Other
Enumeration date
07/28/2015
Last updated
01/28/2019
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