Provider Demographics
NPI:1376936922
Name:BALDERRAMA-MCINNIS, CRISTINA IRENE (OT)
Entity Type:Individual
Prefix:MRS
First Name:CRISTINA
Middle Name:IRENE
Last Name:BALDERRAMA-MCINNIS
Suffix:
Gender:F
Credentials:OT
Other - Prefix:MS
Other - First Name:CRISTINA
Other - Middle Name:IRENE
Other - Last Name:BALDERRAMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:10839 QUARRY PARK
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78233-4681
Mailing Address - Country:US
Mailing Address - Phone:844-206-4512
Mailing Address - Fax:
Practice Address - Street 1:10839 QUARRY PARK
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78233-4681
Practice Address - Country:US
Practice Address - Phone:844-206-4512
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-06
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX116802225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist