Individual
MRS. KAILEY KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
515 W LINGLEVILLE RD, STEPHENVILLE, TX 76401-2211
(254) 965-3611
(254) 965-3618
Mailing address
515 W LINGLEVILLE RD, STEPHENVILLE, TX 76401-2211
(254) 965-3611
(254) 965-3618
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
113459
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
281274501
—
TX
01
—
868T68
BCBS
TX
Enumeration date
05/05/2011
Last updated
01/05/2012
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