Provider Demographics
NPI:1619274024
Name:SWEET, KRISTAN N (OTR)
Entity Type:Individual
Prefix:
First Name:KRISTAN
Middle Name:N
Last Name:SWEET
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4502 CENTERVIEW
Mailing Address - Street 2:STE 215
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78228-1318
Mailing Address - Country:US
Mailing Address - Phone:210-733-7440
Mailing Address - Fax:
Practice Address - Street 1:4502 CENTERVIEW
Practice Address - Street 2:STE 215
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78228-1318
Practice Address - Country:US
Practice Address - Phone:210-733-7440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-21
Last Update Date:2011-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113710225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics