Individual
KIMBERLY GRESHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1001 WSW LOOP 323, TYLER, TX 75701-9416
(903) 509-1313
(903) 509-1383
Mailing address
612 E TWIN CREEKS TRL, TROUP, TX 75789-6708
(936) 556-3756
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
114603
TX
Other
Enumeration date
04/30/2015
Last updated
04/30/2015
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