Individual
MYKENSIE KLEIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
600 N PEARL ST, DALLAS, TX 75201-2822
(214) 252-7600
Mailing address
5828 LLANO AVE, DALLAS, TX 75206-6318
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
215406
TX
Other
Enumeration date
10/23/2018
Last updated
10/23/2018
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