Individual
MS. MARISA MONTALVO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
600 N PEARL ST STE 1050, DALLAS, TX 75201-7495
(214) 252-7681
Mailing address
15302 JUDSON RD # 1318, SAN ANTONIO, TX 78247-1304
(361) 945-7639
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
213475
TX
Other
Enumeration date
08/28/2018
Last updated
08/28/2018
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