Provider Demographics
NPI:1649893173
Name:HOWARD, AUDREY M (CTRS)
Entity type:Individual
Prefix:
First Name:AUDREY
Middle Name:M
Last Name:HOWARD
Suffix:
Gender:F
Credentials:CTRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1339 STEVES AVE STE W
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78210-5026
Mailing Address - Country:US
Mailing Address - Phone:512-667-5020
Mailing Address - Fax:
Practice Address - Street 1:1339 STEVES AVE STE W
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78210-5026
Practice Address - Country:US
Practice Address - Phone:512-667-5020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-19
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation TherapistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225XR0403XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistDriving and Community MobilityGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
58517OtherNATIONAL COUNCIL OF RECREATION THERAPY CERTIIFICATION