Provider Demographics
NPI:1689853624
Name:JONES, DIANE ELIZABETH (OTR)
Entity Type:Individual
Prefix:MS
First Name:DIANE
Middle Name:ELIZABETH
Last Name:JONES
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 1:855 E BASSE RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-1890
Mailing Address - Country:US
Mailing Address - Phone:210-930-1040
Mailing Address - Fax:
Practice Address - Street 1:855 E BASSE RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-1890
Practice Address - Country:US
Practice Address - Phone:210-930-1040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-26
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX107496225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist