Individual
KRISTIAN ASHLEY RAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1050 LAKE VIEW RDG, FORT WORTH, TX 76108-3023
(817) 480-0729
Mailing address
1050 LAKE VIEW RDG, FORT WORTH, TX 76108-3023
(817) 480-0729
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
215831
TX
Other
Enumeration date
09/03/2019
Last updated
09/03/2019
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