Individual
LORI MEDINA-IBARRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
3220 N LOOP 1604 W, SHAVANO PARK, TX 78231-4401
(210) 819-5350
Mailing address
1211 MOUNT RIGA, SAN ANTONIO, TX 78213-2035
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
118092
TX
Other
Enumeration date
03/19/2022
Last updated
03/21/2023
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