Individual
JANEJIRA XAYAVONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
15600 SAN PEDRO AVE STE 305, SAN ANTONIO, TX 78232-3739
(210) 582-5840
Mailing address
5240 COLUMBIA DR, SCHERTZ, TX 78108-2368
(702) 913-8627
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
216420
TX
224Z00000X
Occupational Therapy Assistant
439766
—
Other
Enumeration date
09/21/2022
Last updated
09/21/2022
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