Individual
MARYANN KIMBALL PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1638 VX CR 1803, GRAND SALINE, TX 75140
(903) 962-7595
Mailing address
1638 VZ COUNTY ROAD 1803, GRAND SALINE, TX 75140-3494
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
215295
TX
Other
Enumeration date
08/21/2018
Last updated
08/21/2018
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