Individual
KIMBERLY FAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
106 E JACKSON ST, HARLINGEN, TX 78550-6846
(956) 425-3338
Mailing address
2518 JEFF ST, HARLINGEN, TX 78550-3313
(210) 393-3411
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
209760
TX
Other
Enumeration date
03/11/2008
Last updated
12/23/2013
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