Our Lady of the Lake University
NPI #1063622314 in San Antonio, Texas
Provider Information
- NPI Number
- 1063622314
- Entity Type
- Organization
- Organization Name
- Our Lady of the Lake University
- Primary Specialty
- Speech-Language Pathologist
- Enumeration Date
- May 23, 2007
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 411 SW 24TH ST
- City
- San Antonio
- State
- Texas
- ZIP Code
- 78207-4617
- Phone
- (210) 434-6711
Authorized Official
- Name
- DR. MARY ANN ACEVEDO, PH. D.
- Title
- DIRECTOR
- Phone
- (210) 434-6711
Specialties & Taxonomy Codes
| Specialty |
|---|
| Speech-Language Pathologist |
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