PEDIATRIC ACTION THERAPY, LLC
Restorative Service Providers at Der Flugplatz, Fair Oaks, TX

License number
Texas 111734
Category
Restorative Service Providers
Type
Pediatrics
Owner
Name: MS. DIANA MARCELA BARRERA MOT, OTR, BCBA, C/ND
Title: EXECUTIVE DIRECTOR
Phone: (954) 540-1360
Address
Address
12 Der Flugplatz, Fair Oaks, TX 78006
National Provider ID: 1477875656
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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PEDIATRIC ACTION THERAPY, LLC

Fair Oaks, TX  -  San Antonio, TX

Registration:
Jan 29, 2010
Addresses:
12 Der Flugplatz, Boerne, TX 78006 (Mailing)
24818 Cooper Vly, San Antonio, TX 78255
State ID:
0801224561
Business type:
Domestic Limited Liability Company (LLC)
Managers:
Diana Barrera (Director, President), 24818 Cooper Vly, San Antonio, TX 78255,Sandra Barrera (Manager), 24818 Cooper Vly, San Antonio, TX 78255
Agent:
Diana M Barrera,12 Der Flugplatz, Boerne, TX 78006 (Physical)
TIN:
32041127674

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