Individual
ASHLYNN KENNARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
4801 TROUP HWY STE 800, TYLER, TX 75703-2357
(903) 939-2800
Mailing address
227 PATRICIA CT, TYLER, TX 75702-6243
(817) 433-0700
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
210721
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149984001
—
TX
Enumeration date
08/20/2010
Last updated
08/20/2010
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