Provider Demographics
NPI:1366832495
Name:DANNER, TERESA (OTR, CPST)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:DANNER
Suffix:
Gender:F
Credentials:OTR, CPST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4422 PACK SADDLE PASS
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-1681
Mailing Address - Country:US
Mailing Address - Phone:512-444-3545
Mailing Address - Fax:
Practice Address - Street 1:4422 PACK SADDLE PASS
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-1681
Practice Address - Country:US
Practice Address - Phone:512-444-3545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-27
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112786225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics