Provider Demographics
NPI:1831670033
Name:SERNA, DALIA (COTA)
Entity Type:Individual
Prefix:
First Name:DALIA
Middle Name:
Last Name:SERNA
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:DALIA
Other - Middle Name:SERNA
Other - Last Name:CHAPA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12701 WEST AVE APT 1126
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-1865
Mailing Address - Country:US
Mailing Address - Phone:361-232-0359
Mailing Address - Fax:
Practice Address - Street 1:6211 S NEW BRAUNFELS AVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78223-3175
Practice Address - Country:US
Practice Address - Phone:210-531-0569
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-24
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX212476224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant