Individual
JUSTINE DAVIS/KITTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
3501 S. LOOP 289, LUBBOCK, TX 79414
(806) 796-1774
(806) 796-1714
Mailing address
5507 W 9TH AVENUE, AMARILLO, TX 79106
(806) 468-7611
(806) 468-7603
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
115529
TX
225X00000X
Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
490023
—
VA
Enumeration date
05/17/2012
Last updated
07/25/2018
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