Individual
SANDRA DIANE PENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
168 LEGACY RANCH DR, LA VERNIA, TX 78121-5679
(210) 364-2870
Mailing address
168 LEGACY RANCH DR, LA VERNIA, TX 78121-5679
(210) 364-2870
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT016561
TX
Other
Enumeration date
12/26/2020
Last updated
12/26/2020
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