Provider Demographics
NPI:1184980047
Name:FUNCTIONAL SOLUTIONS THERAPY SERVICES
Entity type:Organization
Organization Name:FUNCTIONAL SOLUTIONS THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ADRIENNE
Authorized Official - Middle Name:
Authorized Official - Last Name:GAITHER
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:210-843-4279
Mailing Address - Street 1:11230 ROCKY TRL
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-4144
Mailing Address - Country:US
Mailing Address - Phone:210-843-4279
Mailing Address - Fax:
Practice Address - Street 1:11230 ROCKY TRL
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-4144
Practice Address - Country:US
Practice Address - Phone:210-843-4279
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-05
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX107792251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health