Provider Demographics
NPI:1316512437
Name:MORA, VIANA (C-IAYTYOGA THERAPIST)
Entity type:Individual
Prefix:MRS
First Name:VIANA
Middle Name:
Last Name:MORA
Suffix:
Gender:F
Credentials:C-IAYTYOGA THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8620 N NEW BRAUNFELS AVE STE 414
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-6362
Mailing Address - Country:US
Mailing Address - Phone:210-334-9642
Mailing Address - Fax:
Practice Address - Street 1:8620 N NEW BRAUNFELS AVE STE 414
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-6362
Practice Address - Country:US
Practice Address - Phone:210-334-9642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-21
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty