Provider Demographics
NPI:1639851009
Name:HERRERA, CRISTINA MARIE (OTR)
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:MARIE
Last Name:HERRERA
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:CRISTINA
Other - Middle Name:MARIE
Other - Last Name:MARTINEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:9119 SHADY RUN
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-5567
Mailing Address - Country:US
Mailing Address - Phone:210-313-5584
Mailing Address - Fax:
Practice Address - Street 1:9119 SHADY RUN
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-5567
Practice Address - Country:US
Practice Address - Phone:210-313-5584
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-03
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX123711225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist