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General NPI Number Information
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NPI Number | 1821729559
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Entity Type | Organization
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Legal Business Name | MAR PEDIATRIC THERAPY LLC
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Dates
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Enumeration Date | 06/22/2022
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Last Update Date | 06/27/2025
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Provider Practice Location Address
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Address Line | 3903 WISEMAN BLVD STE 121B
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City | SAN ANTONIO
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State | TX
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Zip | 78251-4401
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Country | US
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Telephone | 726-242-5113
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Fax | 210-568-4126
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Provider Business Mailing Address
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Address Line | 702 RICHLAND HILLS DR. P.O. BOX 760326
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City | SAN ANTONIO
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State | TX
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Zip | 78245
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Country | US
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Telephone | 602-989-9750
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Fax |
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Authorized Official
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Title or Position | CCC-SLP
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Name | SONIA CARMEN VIOLETTE
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Credential | MS
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Telephone | 602-989-9750
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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