Individual
MARIA KIDWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
406 S MAIN ST, WINNSBORO, TX 75494-3226
(903) 342-6790
Mailing address
4022 HARRIS ST, BELLMEAD, TX 76705-3102
(254) 644-3788
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
211478
TX
Other
Enumeration date
06/27/2017
Last updated
11/01/2019
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