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General NPI Number Information
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NPI Number | 1386443117
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Entity Type | Organization
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Legal Business Name | DB GOODLIFE LLC
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Dates
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Enumeration Date | 03/12/2025
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 3310 OAKWELL CT APT 32302
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City | SAN ANTONIO
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State | TX
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Zip | 78218-5113
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Country | US
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Telephone | 210-256-9859
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Fax |
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Provider Business Mailing Address
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Address Line | 3310 OAKWELL CT APT 32302
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City | SAN ANTONIO
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State | TX
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Zip | 78218-5113
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Country | US
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Telephone | 925-250-7178
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Fax |
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Authorized Official
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Title or Position | OWNER/OCCUPATIONAL THERAPIST
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Name | DENNISE M BENAVIDES
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Credential | OTR, MOT
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Telephone | 925-250-7178
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State |
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